HIV Testing, Care, and Treatment Among Women Who Use Drugs From a Global Perspective

Metsch, Lisa R.; Philbin, Morgan M.; Parish, Carrigan; Shiu, Karen; Frimpong, Jemima A.; Giang, Lê Minh

doi:10.1097/qai.0000000000000660

Cited by 22 publications

(22 citation statements)

References 40 publications

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“…A recent case study in five countries (Vietnam, Argentina, Australia, Ukraine and the United States) found that care continuum data for PWID was only available for the US[48]. Full cascade data among PWID is available from the United States[49,50*] Canada[51*], and India[52], shown in Table 2.…”

Section: Cascade Outcomes In Key Populationsmentioning

confidence: 99%

HIV treatment cascade in MSM, people who inject drugs, and sex workers

Risher

Mayer

Beyrer

2015

Current Opinion in HIV and AIDS

123

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Purpose of review People who inject drugs (PWID), sex workers and men who have sex with men (MSM) simultaneously bear a high burden of HIV and stigma and discrimination. The purpose of this review was to summarize recent information about the understanding of the HIV care cascade among PWID, sex workers, and MSM populations around the globe. Recent findings A review of the published literature relating to the care cascade in these three key populations was conducted. Data on the care cascade among key populations is sparse, particularly for PWID and sex workers. In the twelve countries in which a study or report of the care cascade was available stratified by these populations, all three populations have care cascade outcomes that are far below the 90-90-90 target set by UNAIDS for 2020. Culturally-tailored interventions including co-location of services and peer navigators can improve care cascade outcomes among key populations. Summary Key populations’ care cascade outcomes must be included in international reporting metrics to expand cascade data for these groups. Improving care cascade outcomes in these key populations through culturally-tailored interventions should be a priority in the coming years.

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Section: Cascade Outcomes In Key Populationsmentioning

confidence: 99%

HIV treatment cascade in MSM, people who inject drugs, and sex workers

Risher

Mayer

Beyrer

2015

Current Opinion in HIV and AIDS

123

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“…10 HIV-infected female drug users have significant HIV- and non-HIV-related medical needs, yet, as shown by Metsch et al, HIV testing and access to care remains low. 11 Furthermore, Blankenship et al describe a range of structural barriers that complicate or prevent access to services for drug-using women. 12 …”

Section: Global Burden Of Drug Use and Hiv Among Womenmentioning

confidence: 99%

“…In this issue, Page et al call for greater involvement of drug-using women in drug trials, Metsch et al call for increased research on their access to HIV care, and Auerbach et al call for greater consideration of gender theories in understanding risk environments. 8,11,16 …”

Section: Impact Of Limited Datamentioning

confidence: 99%

“…Shelters offering other services may refuse to admit drug-using women, and admitting drug use can lead to increased instability (e.g., being evicted from housing). 11 …”

Section: Gender-specific Risk Environments For Hiv Faced By Women Whomentioning

confidence: 99%

“…11 In some parts of the world, such as in Eastern Europe and Central Asia, drug treatment, arrest or even admission of drug use leads to registration as a drug user, which can have a range of detrimental and more severe consequences for women than men, including ineligibility for free ART and public housing, loss of one’s driver’s license, and police harassment. 47 Registration can be especially threatening to women whose parental rights can be jeopardized when their drug use is exposed.…”

Section: Gender-specific Risk Environments For Hiv Faced By Women Whomentioning

confidence: 99%

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Women Who Use or Inject Drugs

El‐Bassel

Strathdee

2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Women account for more than half of all individuals living with HIV globally. Despite increasing drug and HIV epidemics among women, females who use drugs are rarely found in research, harm reduction programs, or drug and HIV treatment and care. Women who use drugs continue to face challenges that increase their vulnerability to HIV and other co-morbidities due to high rates of gender-based violence, human rights violations, incarceration, and institutional and societal stigmatization. This special issue emphasizes how the burdens of HIV, drug use and their co-occurring epidemics affect women in a global context. Papers included focus on the epidemiology of HIV, HCV and other co-morbidities; HIV treatment, prevention, and care; and policies affecting the lives of female who use drugs. This issue also highlights the state of the science of biomedical and behavioral research related to women who use drugs. The final paper highlights the major findings of papers covered and presents a call to action regarding needed research, treatment, and preventive services for women who use drugs. To address these needs, we advocate for women-specific thinking and approaches that considers the social, micro, and macro contexts of women’s lives. We present a woman-specific risk environment framework that reflects the unique lives and contexts of women who use drugs and provide a call to action for intervention, prevention, and policies.

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HIV viral load monitoring among key populations in low‐ and middle‐income countries: challenges and opportunities

et al. 2017

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IntroductionKey populations bear a disproportionate HIV burden and have substantial unmet treatment needs. Routine viral load monitoring represents the gold standard for assessing treatment response at the individual and programme levels; at the population‐level, community viral load is a metric of HIV programme effectiveness and can identify “hotspots” of HIV transmission. Nevertheless, there are specific implementation and ethical challenges to effectively operationalize and meaningfully interpret viral load data at the community level among these often marginalized populations.DiscussionViral load monitoring enhances HIV treatment, and programme evaluation, and offers a better understanding of HIV surveillance and epidemic trends. Programmatically, viral load monitoring can provide data related to HIV service delivery coverage and quality, as well as inequities in treatment access and uptake. From a population perspective, community viral load data provides information on HIV transmission risk. Furthermore, viral load data can be used as an advocacy tool to demonstrate differences in service delivery and to promote allocation of resources to disproportionately affected key populations and communities with suboptimal health outcomes. However, in order to perform viral load monitoring for individual and programme benefit, health surveillance and advocacy purposes, careful consideration must be given to how such key population programmes are designed and implemented. For example, HIV risk factors, such as particular sex practices, sex work and drug use, are stigmatized or even criminalized in many contexts. Consequently, efforts must be taken so that routine viral load monitoring among marginalized populations does not cause inadvertent harm. Furthermore, given the challenges of reaching representative samples of key populations, significant attention to meaningful recruitment, decentralization of care and interpretation of results is needed. Finally, improving the interoperability of health systems through judicious use of biometrics or identifiers when confidentiality can be maintained is important to generate more valuable data to inform monitoring programmes.ConclusionsOpportunities for expanded viral load monitoring could and should benefit all those affected by HIV, including key populations. The promise of the increasing routinization of viral load monitoring as a tool to advance HIV treatment equity is great and should be prioritized and appropriately implemented within key population programmatic and research agendas.

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HIV Testing, Care, and Treatment Among Women Who Use Drugs From a Global Perspective

Cited by 22 publications

References 40 publications

HIV treatment cascade in MSM, people who inject drugs, and sex workers

HIV treatment cascade in MSM, people who inject drugs, and sex workers

Women Who Use or Inject Drugs

HIV viral load monitoring among key populations in low‐ and middle‐income countries: challenges and opportunities

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