Undisclosed HIV infection and antiretroviral therapy use in the Kenya AIDS indicator survey 2012

Kim, Andrea A.; Mukui, Irene; Young, Peter W.; Mirjahangir, Joy; Mwanyumba, Sophie; Wamicwe, Joyce; Bowen, Nancy; Wiesner, Lubbe; Ng’ang’a, Lucy; Cock, Kevin M. De

doi:10.1097/qad.0000000000001227

Cited by 61 publications

(64 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, the results from ZIMPHIA on HIV status are based on self‐reported data and hence must be interpreted with caution. It is highly likely that not all people diagnosed with HIV report as having been diagnosed when asked; this has been demonstrated in other surveys 3 and if this is the case, it would result in an underestimation in the proportion diagnosed.…”

Section: Discussionmentioning

confidence: 94%

“…However, there is still room for further advancement. In Zimbabwe, a 2016 population‐based survey (Zimbabwe Population‐Based HIV Impact Assessment (ZIMPHIA)) suggests that a quarter of PLHIV were not aware of their HIV status in 2016 2, although there is likely to be some under‐reporting of HIV diagnosis 3. Of those reporting having been diagnosed, 86.8% self‐reported use of antiretroviral therapy (ART) and, among these people, 86.5% had viral suppression 2.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

90‐90‐90 by 2020? Estimation and projection of the adult HIV epidemic and ART programme in Zimbabwe – 2017 to 2020

Bansi‐Matharu¹,

Cambiano²,

Apollo

et al. 2018

J Intern AIDS Soc

View full text Add to dashboard Cite

IntroductionThe 90‐90‐90 targets set by the United Nations aspire to 73% of people living with HIV (PLHIV) being virally suppressed by 2020. Using the HIV Synthesis Model, we aim to mimic the epidemic in Zimbabwe and make projections to assess whether Zimbabwe is on track to meet the 90‐90‐90 targets and assess whether recently proposed UNAIDS HIV transition metrics are likely to be met.MethodsWe used an approximate Bayesian computation approach to identify model parameter values which result in model outputs consistent with observed data, evaluated using a calibration score. These parameter values were then used to make projections to 2020 to compare with the 90‐90‐90 targets and other key indicators. We also calculated HIV transition metrics proposed by UNAIDS (percentage reduction in new HIV infections and AIDS‐related mortality from 2010 to 2020, absolute rate of new infections and AIDS‐related mortality, incidence–mortality ratio and incidence–prevalence ratios).ResultsAfter calibration, there was general agreement between modelled and observed data. The median predicted outcomes in 2020 were: proportion of PLHIV (aged 15 to 65) diagnosed 0.91 (90% uncertainty range 0.87, 0.94) (0.84 men, 0.95 women); of those diagnosed, proportion on treatment 0.92 (0.90, 0.93); of those receiving treatment, proportion with viral suppression 0.86 (0.81, 0.91). This results in 72% of PLHIV having viral suppression in 2020. We estimated a percentage reduction of 36.5% (13.7% increase to 67.4% reduction) in new infections from 2010 to 2020, and of 30.4% (9.7% increase to 56.6% reduction) in AIDS‐related mortality (UNAIDS target 75%). The modelled absolute rates of HIV incidence and AIDS‐related mortality in 2020 were 5.48 (2.26, 9.24) and 1.93 (1.31, 2.71) per 1000 person‐years respectively. The modelled incidence–mortality ratio and incidence–prevalence ratios in 2020 were 1.05 (0.46, 1.66) and 0.009 (0.004, 0.013) respectively.ConclusionsOur model was able to produce outputs that are simultaneously consistent with an array of observed data and predicted that while the 90‐90‐90 targets are within reach in Zimbabwe, increased efforts are required in diagnosing men in particular. Calculation of the HIV transition metrics suggest increased efforts are needed to bring the HIV epidemic under control.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

90‐90‐90 by 2020? Estimation and projection of the adult HIV epidemic and ART programme in Zimbabwe – 2017 to 2020

Bansi‐Matharu¹,

Cambiano²,

Apollo

et al. 2018

J Intern AIDS Soc

View full text Add to dashboard Cite

show abstract

“…Electro Spray Ionisation (ESI) was used for ion production. 24,25 Samples that fell above the lower limit of detection for either of the antiretroviral drugs tested were classified as positive for ART use. The time from ingestion to reaching this threshold has been estimated at 1.5 days for 3TC.…”

Section: Methodsmentioning

confidence: 99%

“…The time from ingestion to reaching this threshold has been estimated at 1.5 days for 3TC. 24 Ethical approval for HAALSI was obtained from the University of the Witwatersrand, the Harvard T.H. Chan School of Public Health, and the Mpumalanga Provincial Research and Ethics Committee.…”

Section: Methodsmentioning

confidence: 99%

The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa

Manne‐Goehler

Montana

Gómez‐Olivé

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background The prevalence of diabetes and hypertension has increased in HIV-positive populations but there is limited understanding of the role that ART programs play in the delivery of services for these conditions. The aim of this study is to assess the relationship between ART use and utilization of healthcare services for diabetes and hypertension. Methods Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa is a cohort of 5,059 adults. The baseline study collects biomarker-based data on HIV, ART, diabetes and hypertension and self-reported data on healthcare utilization. We calculated differences in care utilization for diabetes and hypertension by HIV and ART status and used multivariable logistic regressions to estimate the relationship between ART use and utilization of services for these conditions, controlling for age, sex, body mass index (BMI), education and household wealth quintile. Results Mean age, BMI, hypertension and diabetes prevalence were lower in the HIV-positive population (all p<0.001). Multivariable logistic regression showed that ART use was significantly associated with greater odds of blood pressure (aOR 1.27 95% CI 1.04–1.55) and blood sugar measurement (aOR 1.26, 95% CI 1.05–1.51), counseling regarding exercise (aOR 1.57, 95% CI 1.11–2.22), awareness of hypertension diagnosis (aOR 1.52, 95% CI 1.12–2.05) and treatment for hypertension (aOR 1.63, 95% CI 1.21–2.19). Conclusions HIV-positive patients who use ART are more likely to have received healthcare services for diabetes and hypertension. This apparent ART advantage suggests that ART programs may be a vehicle for strengthening health systems for chronic care.

show abstract

“…8,9 However, neither of these studies addressed the utility of SR-ART data in areas with hyperendemic HIV prevalence or among older adults. These studies also involved retrospective analyses of data collected in 2011 and 2012, respectively.…”

Section: Introductionmentioning

confidence: 99%

ART Denial: Results of a Home-Based Study to Validate Self-reported Antiretroviral Use in Rural South Africa

et al. 2018

Self Cite

View full text Add to dashboard Cite

OBJECTIVE: There is increasing interest in home based testing and treatment of HIV to expand access to treatment in sub-Saharan Africa. Such programs rely on self-reported HIV history and use of antiretroviral therapy (ART). However, the accuracy of self-reported ART use in community settings is not well described. In this study, we compared self-reported ART (SR-ART) use in a home based survey against biological exposure to ART (BE-ART), in a population study of older adults in South Africa. METHODS: Health and Aging in Africa: a Longitudinal Study of an INDEPTH community in South Africa (HAALSI) is a cohort of adults aged 40+. The baseline home-based interview included self-reported HIV status and ART use. All participants also underwent biological testing for HIV antibodies, viral load and exposure to emtricitabine (FTC) or lamivudine (3TC), which are included in all first-line and second-line ART regimens in the public-sector South African HIV program. We calculated the performance characteristics for SR-ART compared to BE-ART and fit multivariable logistic regression models to identify correlates of invalid SR-ART responses. RESULTS: Of 4,560 HAALSI participants with a valid HIV test result available, 1,048 (23%) were HIV-positive and 734 [70% of people living with HIV (PLWH)] were biologically validated ART users (BE-ART). The sensitivity of SR-ART use was 64% (95% CI: 61–68%) and the specificity was 94% (95% CI: 91–96%); the positive predictive value (PPV) was 96% (95% CI: 94–98%) and negative predictive value (NPV) was 52% (95% CI: 48–56%). We found no sociodemographic predictors of accurate SR-ART use. CONCLUSIONS: Over one in three individuals with detectable ART in their blood denied current ART use during a home-based interview. These results demonstrate ongoing stigma related to HIV and its treatment, and have important implications for community health worker programs, clinical programs, and research studies planning community-based ART initiation in the region.

show abstract

Undisclosed HIV infection and antiretroviral therapy use in the Kenya AIDS indicator survey 2012

Cited by 61 publications

References 20 publications

90‐90‐90 by 2020? Estimation and projection of the adult HIV epidemic and ART programme in Zimbabwe – 2017 to 2020

90‐90‐90 by 2020? Estimation and projection of the adult HIV epidemic and ART programme in Zimbabwe – 2017 to 2020

The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa

ART Denial: Results of a Home-Based Study to Validate Self-reported Antiretroviral Use in Rural South Africa

Contact Info

Product

Resources

About