Time Spent with HIV Viral Load &gt; 1500 Copies/mL Among Persons Engaged in Continuity HIV Care in an Urban Clinic in the United States, 2010–2015

Lesko, Catherine R.; Lau, Bryan; Chander, Geetanjali; Moore, Richard D.

doi:10.1007/s10461-018-2085-6

Cited by 11 publications

(14 citation statements)

References 39 publications

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“…Specifically, one cohort study saw increases in uptake in ART for women (aPR 1.15; 95% CI 1.06, 1.24) and men (aPR 1.06; 95% CI 1.01, 1.10) over the course of the study period (Hoots et al, 2017). In contrast, Lesko, et al, who reported outcomes stratified by gender and race found that white women had the lowest percentage of person‐time in care after ART initiation and that both white and Black women had the greatest percentage of person‐time in care with a detectable HIV viral load (>1500 copies/ml) compared to male counterparts (Lesko et al, 2018). That study, however, only displayed percentages of person‐time stratified by race and gender with ART and viral load outcomes, without conducting relevant multivariable analysis or testing for differences between the groups.…”

Section: Resultsmentioning

confidence: 96%

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Barriers and facilitators to primary care engagement for people who inject drugs: A systematic review

Heidari

Tormohlen

Dangerfield

et al. 2022

J of Nursing Scholarship

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Introduction People who inject drugs (PWID) have a greater burden of multimorbid chronic diseases than the general population. However, little attention has been paid to the engagement in primary care for services related specifically to injection drug use and management of underlying chronic comorbid diseases for this population. This systematic review identified facilitators and barriers to healthcare engagement in the primary care setting among PWID. Design and Methods Studies were identified by a literature search of PubMed, CINAHL, and EMBASE, and by searching the references of retrieved articles. Studies were included if they measured active injection drug use, and outcomes related to primary care engagement characterized by: diagnosis of a health condition, linkage or retention in care, health condition‐related outcomes, and reported patient–provider relationship. Results Twenty‐three articles were included. Using the behavioral model, factors within predisposing, enabling, need, and health behavior domains were identified. Having co‐located services and a positive patient–provider relationship were among the strongest factors associated with healthcare utilization and engagement while active injection drug use was associated with decreased engagement. Conclusions To our knowledge, this is the only review of evidence that has examined factors related to primary care engagement for people who inject drugs. Most articles were observational studies utilizing descriptive designs. Although the assessment of the evidence was primarily rated ‘Good’, this review identifies a significant need to improve our understanding of primary care engagement for PWID. Future research and intervention strategies should consider these findings to better integrate the holistic care needs of PWID into primary care to reduce morbidity and mortality associated with injection drug use and chronic disease. Clinical relevance Primary care engagement is important for preventative care, early diagnosis of disease, and management of chronic diseases, including addressing problems of substance use. This review highlights factors nurses can utilize to facilitate primary care engagement of PWID.

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Section: Resultsmentioning

confidence: 96%

“…Predisposing factors were not well measured or well represented across the studies with a few exceptions. Only one study stratified analysis by sex or gender but did not conduct analyses or provide effect estimates of engagement in care (Lesko et al, 2018). As a whole, measures and comparisons of race and ethnicity were also inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to primary care engagement for people who inject drugs: A systematic review

Heidari

Tormohlen

Dangerfield

et al. 2022

J of Nursing Scholarship

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“…This cutoff was selected as an established indicator of a low viral load where HIV transmission is unlikely to occur. 29 , 30 , 31 These measures were collected through patient records, which contained indicators unavailable through point-of-care data collection methods, such as laboratory test results. Medical record review used data from Kazakhstan’s National Electronic HIV Case Management System, a government-approved database for the collection, storage, transfer, and analysis of epidemiological, laboratory, and clinical data on all HIV-positive registered cases.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of an Intervention to Improve HIV Service Delivery for People Who Inject Drugs in Kazakhstan

El‐Bassel

McCrimmon

et al. 2022

JAMA Netw Open

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ImportanceThe increasing HIV incidence rates and suboptimal rates of testing, engagement, and retention in care for people who inject drugs (PWID) in Kazakhstan underscore the need for effective HIV care continuum interventions for PWID.ObjectiveTo determine the effectiveness of the Bridge HIV care continuum intervention implemented in needle and syringe programs (NSPs) in Kazakhstan.Design, Setting, and ParticipantsThis stepped-wedge cluster trial was conducted from February 2017 to May 2020, with implementation beginning sequentially across 3 cities (Almaty, Karaganda-Temirtau, and Shymkent) in August 2017, January 2018, and May 2019. Intervention effect sizes were estimated via population-averaged models, and hypothesis testing relied on a permutation testing approach. The primary unit of analysis was an NSP. Data analysis was performed from October 2020 to April 2022.InterventionsThe intervention addresses the full HIV care continuum: identification, testing, referral to services, and linkage to HIV care. The 3 intervention components were (1) a social network strategy, a peer-driven recruitment approach for HIV testing; (2) HIV counseling, rapid testing, and referral following international and national guidelines and protocols; and (3) enhanced antiretroviral treatment and access to services.Main Outcomes and MeasuresThe primary outcomes were the effectiveness of implementing Bridge’s enhanced service integration approach in increasing the number of PWID served at NSPs, increasing the number of PWID who are tested for HIV in NSPs, and improving linking HIV-positive PWID with HIV care. Secondary outcomes included numbers of clients registered for HIV care, initiation of antiretroviral therapy, and viral suppression.ResultsTwenty-four NSPs (8 in each city) served a total of 1225 PWID (369 in Almaty, 618 in Karaganda-Temirtau, and 238 in Shymkent) at the preimplementation study step; 1015 clients (82.9%) were male, and the mean (SD) age was 36.7 (7.1) years. Compared with preimplementation study steps, during Bridge intervention implementation steps, NSPs experienced a significant increase in the number of PWID clients registered (incidence rate ratio, 2.37; 95% CI, 1.48-3.78) and the number of PWID who received rapid HIV tests (incidence rate ratio, 3.98; 95% CI, 2.30-6.90). No significant increase in referral to HIV care was observed. The study also found significant support for secondary outcomes of antiretroviral therapy initiation and the number of clients who achieved viral suppression.Conclusions and RelevanceIn this stepped-wedge cluster trial, the findings suggest that implementation of the Bridge intervention was associated with significant improvement in several steps in the continuum of HIV care for PWID in Kazakhstan.Trial RegistrationClinicalTrials.gov Identifier: NCT02796027

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“…In a longitudinal study of patients in continuity care, the time spent with a viral load >1500 copies/mL was evaluated. Hazardous alcohol use, recent drug use, black race, and age were highly associated with failure to maintain an HIV <1500 copies/mL [130]. In the Women's Interagency HIV Study, heavy drinking was associated with failure to remain virally suppressed as well [26].…”

Section: Alcohol and Hivmentioning

confidence: 99%

Drugs of Abuse and Their Impact on Viral Pathogenesis

Blackard

Sherman

2021

Viruses

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Commonly misused substances such as alcohol, cocaine, heroin, methamphetamine, and opioids suppress immune responses and may impact viral pathogenesis. In recent years, illicit use of opioids has fueled outbreaks of several viral pathogens, including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). This review focuses on the myriad of mechanisms by which drugs of abuse impact viral replication and disease progression. Virus–drug interactions can accelerate viral disease progression and lead to increased risk of virus transmission.

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Time Spent with HIV Viral Load > 1500 Copies/mL Among Persons Engaged in Continuity HIV Care in an Urban Clinic in the United States, 2010–2015

Cited by 11 publications

References 39 publications

Barriers and facilitators to primary care engagement for people who inject drugs: A systematic review

Barriers and facilitators to primary care engagement for people who inject drugs: A systematic review

Effectiveness of an Intervention to Improve HIV Service Delivery for People Who Inject Drugs in Kazakhstan

Drugs of Abuse and Their Impact on Viral Pathogenesis

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