Implementation and Operational Research

Grimsrud, Anna; Lesosky, Maia; Kalombo, Cathy; Bekker, Linda‐Gail; Myer, Landon

doi:10.1097/qai.0000000000000863

Cited by 119 publications

(59 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The history of rights-based health interventions, including for people who inject drugs, has advanced through a series of small victories [40].The requirement to attend to the context, practices and priorities of key populations applies to all HIV programme implementation, and the emergence of interest in PrEP presents an opportunity to examine these factors more deeply. Current focus and debate on PrEP implementation provides an opportunity for people who inject drugs who are interested to shape the development and design of PrEP services.…”

Section: Provision and Uptake Of Prepmentioning

confidence: 99%

“…Almost four years after PrEP approval by the US Food and Drug Administration [40], PrEP implementation in the United States remains a work in progress: the number of people receiving PrEP started to increase rapidly in about 2014 [41]. Elsewhere, PrEP implementation has been limited due to a number of issues.…”

Section: Prep Implementation Issuesmentioning

confidence: 99%

“…And like anything else, if you're not at the table, but you're just being a [PrEP] naysayer, you're going to be left out of how these things actually get rolled out. [8, p. 10] It is important to remember that people who inject drugs have the same sexual rights and sexual health needs as those in the general population [39] and that in contexts where HIV transmission is at least partly driven by unsafe injecting in combination with risky sex, HIV prevention impact achieved for people who inject drugs can influence HIV transmission dynamics in the wider population [40].…”

Section: Prep and Harm Reduction Servicesmentioning

confidence: 99%

“…Text messaging and mobile application interventions to improve PrEP adherence are currently being tested [38], which may be relatively simple ways to enhance adherence using technology that is highly familiar to youth. The use of adherence clubs and other social support groups has shown promise as a cost-effective strategy for HIV treatment adherence among adolescents and may be a strategy for PrEP users as well [39,40]. Although more comprehensive service provisions may increase cost, the resulting HIV prevention possibilities for youth will have broad social and economic benefits [41].…”

Section: Ethical and Legal Issues For Adolescentsmentioning

confidence: 99%

“…Demonstration projects to explore PrEP implementation in those populations are a priority. Medication adherence in younger women has also been recognized as a significant challenge [39,40]. Risk assessment tools have been designed for men who have sex with men (MSM) and people who inject drugs (PWID) but have not been critically evaluated yet in terms of their usefulness in PrEP implementation.…”

Section: Ensuring Safetymentioning

confidence: 99%

See 4 more Smart Citations

Global implementation of PrEP as part of combination HIV prevention - Unsolved challenges

Cáceres¹,

Bekker²,

Godfrey‐Faussett³

2016

Journal of the International AIDS Society

Self Cite

View full text Add to dashboard Cite

Section: Provision and Uptake Of Prepmentioning

confidence: 99%

Section: Prep Implementation Issuesmentioning

confidence: 99%

Section: Prep and Harm Reduction Servicesmentioning

confidence: 99%

Section: Ethical and Legal Issues For Adolescentsmentioning

confidence: 99%

Section: Ensuring Safetymentioning

confidence: 99%

See 3 more Smart Citations

Global implementation of PrEP as part of combination HIV prevention - Unsolved challenges

Cáceres¹,

Bekker²,

Godfrey‐Faussett³

2016

Journal of the International AIDS Society

Self Cite

View full text Add to dashboard Cite

Changing Donor Funding and the Challenges of Integrated HIV Treatment

Nattrass

Hodes

Cluver

2016

AMA Journal of Ethics

View full text Add to dashboard Cite

Donor financing for HIV prevention and treatment has shifted from supporting disease-specific ("vertical") programs to health systems strengthening ("horizontal") programs intended to integrate all aspects of care. We examine the consequences of shifting resources from three perspectives: first, through a broad analysis of the changing policy context of health care financing; second, through an account of changing priorities for HIV treatment in South Africa; and third, through a description of some clinical consequences that the authors observed in a research study examining adherence to antiretroviral therapy (ART) and sexual health among adolescents. We note that AIDS responses are neither completely vertical nor horizontal but rather increasingly diagonal, as disease-specific protocols operate alongside integrated supply chain management, human resource development, and preventive screening. We conclude that health care programs are better conceived of as networks of policies requiring different degrees of integration into communities.

show abstract

STACKing the odds for adolescent survival: health service factors associated with full retention in care and adherence amongst adolescents living with HIV in South Africa

et al. 2018

View full text Add to dashboard Cite

IntroductionThere are two million HIV‐positive adolescents in southern Africa, and this group has low retention in care and high mortality. There is almost no evidence to identify which healthcare factors can improve adolescent self‐reported retention. This study examines factors associated with retention amongst antiretroviral therapy (ART)‐initiated adolescents in South Africa.MethodsWe collected clinical records and detailed standardized interviews (n = 1059) with all 10‐ to 19 year‐olds ever initiated on ART in all 53 government clinics of a health subdistrict, and community traced to include lost‐to‐follow‐up (90.1% of eligible adolescents interviewed). Associations between full self‐reported retention in care (no past‐year missed appointments and 85% past‐week adherence) and health service factors were tested simultaneously in sequential multivariate regression and marginal effects modelling, controlling for covariates of age, gender, urban/rural location, formal/informal housing, maternal and paternal orphanhood, vertical/horizontal HIV infection, overall health, length of time on ART and type of healthcare facility.ResultsAbout 56% of adolescents had self‐reported retention in care, validated against lower detectable viral load (AOR: 0.63, CI: 0.45 to 0.87, p = 0.005). Independent of covariates, five factors (STACK) were associated with improved retention: clinics Stocked with medication (OR: 3.0, CI: 1.6 to 5.5); staff with Time for adolescents (OR: 2.7, CI: 1.8 to 4.1); adolescents Accompanied to the clinic (OR: 2.3, CI: 1.5 to 3.6); enough Cash to get to clinic safely (OR: 1.4, CI: 1.1 to 1.9); and staff who are Kind (OR: 2.6, CI: 1.8 to 3.6). With none of these factors, 3.3% of adolescents reported retention. With all five factors, 69.5% reported retention.ConclusionsThis study identifies key intervention points for adolescent retention in HIV care. A basic package of clinic and community services has the potential to STACK the odds for health and survival for HIV‐positive adolescents.

show abstract

Implementation and Operational Research

Abstract: CACs are associated with reduced risk of LTFU compared with facility-based care. Community-based models represent an important development to facilitate ART delivery and possibly improve patient outcomes.

Cited by 119 publications

References 24 publications

Global implementation of PrEP as part of combination HIV prevention - Unsolved challenges

Global implementation of PrEP as part of combination HIV prevention - Unsolved challenges

Changing Donor Funding and the Challenges of Integrated HIV Treatment

STACKing the odds for adolescent survival: health service factors associated with full retention in care and adherence amongst adolescents living with HIV in South Africa

Contact Info

Product

Resources

About