IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents

Bekker, Linda‐Gail; Montaner, Julio S. G.; Ramos, Celso; Sherer, Renslow; Celletti, Francesca; Cutler, Blayne; Dabis, François; Granich, Reuben; Greenberg, Alan E.; Goldenberg, Shira M.; Hull, Mark; Kerr, Thomas; Kurth, Ann; Mayer, Kenneth H.; Metsch, Lisa R.; Mugo, Nelly; Munderi, Paula; Nachega, Jean B.; Nosyk, Bohdan; Saavedra, Jorge; Wolters, Theresa; Young, Benjamin; Zuniga, José M; Agins, Bruce; Amico, K. Rivet; Begovać, Josip; Beyrer, Chris; Cahn, Pedro; Cairns, Gus; Cohen, Mardge H.; Deering, Kathleen; Rı́o, Carlos del; Diaz, Ricardo S.; Dombrowski, Julia C.; Doshi, Rupali; El‐Sadr, Wafaa; Futterman, Donna; Geretti, Anna María; Guaraldi, Giovanni; Halloran, Jim; Gordon, Christopher M.; Kahana, Shoshana Y.; Lama, Javier R.; Lima, Viviane D.; Linsk, Nathan L.; Monforte, Antonella d’Arminio; Nelson, Mark; Negussie, Eyerusalem; Phanuphak, Praphan; Scott, James; Shaffer, Douglas; Shannon, Kate; Spaulding, Anne C.; Valerio, Carlos J; Wu, Zunyou; Żakowicz, Anna; Zorrilla, Carmen

doi:10.1177/2325957415613442

Cited by 99 publications

(49 citation statements)

References 268 publications

(352 reference statements)

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“…Active engagement of peers in the design and delivery of HIV services has also been promoted globally in recent years [1,26]. Yet, the evidence supporting the beneficial role of peers in the continuum of the HIV services is limited and is sometimes controversial [5,28–30].…”

Section: Discussionmentioning

confidence: 99%

Optimizing linkage to care and initiation and retention on treatment of adolescents with newly diagnosed HIV infection

Ruria¹,

Masaba²,

Kose³

et al. 2017

Aids

117

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Objective:Unsuccessful linkage to care and treatment increases adolescent HIV-related morbidity and mortality. This study evaluated the effect of a novel adolescent and youth Red Carpet Program (RCP) on the timing and outcomes of linkage to care.Design:A prepost implementation evaluation of the pilot RCP program.Settings:Healthcare facilities (HCFs) and schools in Homa Bay County, Kenya.Study participants:HIV-infected adolescents (15–19 years) and youth (20–21 years).Interventions:RCP provided fast-track peer-navigated services, peer counseling, and psychosocial support at HCFs and schools in six Homa Bay subcounties in 2016. RCP training and sensitization was implemented in 50 HCFs and 25 boarding schools.Main outcome measures:New adolescent and youth HIV diagnosis, linkage to and retention in care and treatment.Results:Within 6 months of program rollout, 559 adolescents and youths (481 women; 78 men) were newly diagnosed with HIV (15–19 years n = 277; 20–21 years, n = 282). The majority (n = 544; 97.3%) were linked to care, compared to 56.5% at preimplementation (P < 0.001). All (100.0%; n = 559) adolescents and youths received peer counseling and psychosocial support, and the majority (n = 430; 79.0%) were initiated on treatment. Compared to preimplementation, the proportion of adolescents and youths who were retained on treatment increased from 66.0 to 90.0% at 3 months (P < 0.001), and from 54.4 to 98.6% at 6 months (P < 0.001).Conclusion:Implementation of RCP was associated with significant improvement in linkage to and early retention in care among adolescent and youth. The ongoing study will fully assess the efficacy of this linkage-to-care approach.

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Section: Discussionmentioning

confidence: 99%

Optimizing linkage to care and initiation and retention on treatment of adolescents with newly diagnosed HIV infection

Ruria¹,

Masaba²,

Kose³

et al. 2017

Aids

117

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“…17 However, there is still considerable room to increase provider’s delivery of brief prevention messages, especially to those who are not durably suppressed as recommended by the prevention, treatment, and care guidelines. 2,18, 19 Several integrated interventions that target multiple risk behaviors simultaneously have shown to improve risk reduction behaviors and care outcomes of HIV-infected person. 20 Those integrated interventions are additional resources for providers to consider when referring patients to more intensive interventions.…”

Section: Discussionmentioning

confidence: 99%

Durable Viral Suppression and Transmission Risk Potential Among Persons With Diagnosed HIV Infection: United States, 2012–2013

et al. 2016

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Background To examine durable viral suppression, cumulative viral load (VL) burden, and transmission risk potential among HIV-diagnosed persons in care. Methods Using data from the National HIV Surveillance System from 17 jurisdictions with complete reporting of VL test results, we determined the percentage of persons in HIV care who achieved durable viral suppression (all VL results <200 copies/mL) and examined viremia copy-years and time spent above VL levels that increase the risk of HIV transmission during 2012–2013. Results Of 265,264 persons in HIV care in 2011, 238,641 had at least two VLs in 2012–2013. The median number of VLs per individual during the 2-year period was five. Approximately 62% had durable viral suppression. The remaining 38% had high VL burden (geometric mean of viremia copy-years: 7,261) and spent an average of 438 days, 316 days, and 215 days (60%, 43.2%, and 29.5% of the 2-year time) above 200, 1,500, and 10,000 copies/mL. Women, blacks/African Americans, Hispanics/Latinos, persons with HIV infection attributed to transmission other than male-to-male sexual contact, younger age groups, and persons with gaps in care had higher viral burden and transmission risk potential. Conclusions Two-thirds of persons in HIV care had durable viral suppression during a 2-year period. One-third had high VL burden and spent substantial time above VL levels with increased risk of onward transmission. More intervention efforts are needed to improve retention in care and medication adherence so that more persons in HIV care achieve durable viral suppression.

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“…Increasing awareness of the continuum of care—for example, through national treatment and/or service delivery guidelines—and providing evidence-based recommendations to improve the testing and care environment, may also improve the care continuum [34]. …”

Section: Discussionmentioning

confidence: 99%

The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges

Gourlay

Noori

Pharris

et al. 2017

Clinical Infectious Diseases

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IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents

Abstract: Recommendations are provided for interventions to optimize the HIV care environment; increase HIV testing and linkage to care, treatment coverage, retention in care, and viral suppression; and monitor the HIV care continuum.

Cited by 99 publications

References 268 publications

Optimizing linkage to care and initiation and retention on treatment of adolescents with newly diagnosed HIV infection

Optimizing linkage to care and initiation and retention on treatment of adolescents with newly diagnosed HIV infection

Durable Viral Suppression and Transmission Risk Potential Among Persons With Diagnosed HIV Infection: United States, 2012–2013

The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges

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