共查询到20条相似文献,搜索用时 15 毫秒
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Mi Young Ahn Awachana Jiamsakul Suwimon Khusuwan Vohith Khol Thuy T Pham Romanee Chaiwarith Anchalee Avihingsanon Nagalingeswaran Kumarasamy Wing Wei Wong Sasisopin Kiertiburanakul Sanjay Pujari Kinh V Nguyen Man Po Lee Adeeba Kamarulzaman Fujie Zhang Rossana Ditangco Tuti P Merati Evy Yunihastuti Oon Tek Ng Benedict L H Sim Junko Tanuma Winai Ratanasuwan Jeremy Ross Jun Yong Choi 《Journal of the International AIDS Society》2019,22(2)
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Seth C Kalichman Chauncey Cherry Moira O Kalichman Christopher Washington Tamar Grebler Cindy Merely Brandi Welles Jennifer Pellowski Christopher Kegler 《Journal of the International AIDS Society》2015,18(1)
Introduction
Antiretroviral therapy (ART) improves the health of people living with HIV and has the potential to reduce HIV infectiousness, thereby preventing HIV transmission. However, the success of ART for HIV prevention hinges on sustained ART adherence and avoiding sexually transmitted infections (STI).Objectives
To determine the sexual behaviours and HIV transmission risks of individuals with suppressed and unsuppressed HIV replication (i.e., viral load).Methods
Assessed HIV sexual transmission risks among individuals with clinically determined suppressed and unsuppressed HIV. Participants were 760 men and 280 women living with HIV in Atlanta, GA, USA, who completed behavioural assessments, 28-daily prospective sexual behaviour diaries, one-month prospective unannounced pill counts for ART adherence, urine screening for illicit drug use and medical record chart abstraction for HIV viral load.Results
Individuals with unsuppressed HIV demonstrated a constellation of behavioural risks for transmitting HIV to uninfected sex partners that included symptoms of STI and substance use. In addition, 15% of participants with suppressed HIV had recent STI symptoms/diagnoses, indicating significant risks for sexual infectiousness despite their HIV suppression in blood plasma. Overall, 38% of participants were at risk for elevated sexual infectiousness and just as many engaged in unprotected sexual intercourse with non-HIV-infected partners.Conclusions
Implementation strategies for using HIV treatments as HIV prevention requires enhanced behavioural interventions that extend beyond ART to address substance use and sexual health that will otherwise undermine the potential preventive impact of early ART. 相似文献7.
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Orlanda Q Goh Donn J Colby Suteeraporn Pinyakorn Carlo Sacdalan Eugne Kroon Phillip Chan Nitiya Chomchey Ratchapong Kanaprach Peeriya Prueksakaew Duanghathai Suttichom Rapee Trichavaroj Serena Spudich Merlin L Robb Praphan Phanuphak Nittaya Phanuphak Jintanat Ananworanich 《Journal of the International AIDS Society》2019,22(7)
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Introduction
Emerging HIV epidemics have been documented among people who inject drugs (PWID) in the Middle East and North Africa (MENA). This study estimates the HIV incidence among PWID due to sharing needles/syringes in MENA. It also delineates injecting drug use role as a driver of the epidemic in the population, and estimates impact of interventions.Methods
A mathematical model of HIV transmission among PWID was applied in seven MENA countries with sufficient and recent epidemiological data and HIV prevalence ≥1% among PWID. Estimations of incident and/or prevalent infections among PWID, ex‐PWID and sexual partners of infected current and ex‐PWID were conducted.Results
The estimated HIV incidence rate for 2017 among PWID ranged between 0.7% per person‐year (ppy) in Tunisia and 7.8% ppy in Pakistan, with Libya being an outlier (24.8% ppy). The estimated number of annual new infections was lowest in Tunisia (n = 79) and Morocco (n = 99), and highest in Iran and Pakistan (approximately n = 6700 each). In addition, 20 to 2208 and 5 to 837 new annual infections were estimated across the different countries among sexual partners of PWID and ex‐PWID respectively. Since epidemic emergence, the number of total ever acquired incident infections across countries was 706 to 90,015 among PWID, 99 to 18,244 among sexual partners of PWID, and 16 to 4360 among sexual partners of ex‐PWID. The estimated number of prevalent infections across countries was 341 to 23,279 among PWID, 119 to 16,540 among ex‐PWID, 67 to 10,752 among sexual partners of PWID, and 12 to 2863 among sexual partners of ex‐PWID. Increasing antiretroviral therapy (ART) coverage to the global target of 81% – factoring in ART adherence and current coverage – would avert about half of new infections among PWID and their sexual partners. Combining ART with harm reduction could avert over 90% and 70% of new infections among PWID and their sexual partners respectively.Conclusions
There is considerable HIV incidence among PWID in MENA. Of all new infections ultimately due to injecting drug use, about 75% are among PWID and the rest among sexual partners. Of all prevalent infections ultimately attributed to injecting drug use as epidemic driver, about half are among PWID, 30% among ex‐PWID and 20% among sexual partners of PWID and ex‐PWID. These findings call for scale‐up of services for PWID, including harm reduction as well as testing and treatment services.15.
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Euphemia L Sibanda Marc d'Elbe Galven Maringwa Nancy Ruhode Mary Tumushime Claudius Madanhire Jason J Ong Pitchaya Indravudh Constancia Watadzaushe Cheryl C Johnson Karin Hatzold Miriam Taegtmeyer James R Hargreaves Elizabeth L Corbett Frances M Cowan Fern Terris‐Prestholt 《Journal of the International AIDS Society》2019,22(Z1)
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Alexandra B Collins Surita Parashar Robert S Hogg Saranee Fernando Catherine Worthington Patrick McDougall Rosalind Baltzer Turje Ryan McNeil 《Journal of the International AIDS Society》2017,20(1)
Introduction : Social‐structural inequities impede access to, and retention in, HIV care among structurally vulnerable people living with HIV (PLHIV) who use drugs. The resulting disparities in HIV‐related outcomes among PLHIV who use drugs pose barriers to the optimization of HIV treatment as prevention (TasP) initiatives. We undertook this study to examine engagement with, and impacts of, an integrated HIV care services model tailored to the needs of PLHIV who use drugs in Vancouver, Canada – a setting with a community‐wide TasP initiative. Methods : We conducted qualitative interviews with 30 PLHIV who use drugs recruited from the Dr. Peter Centre, an HIV care facility operating under an integrated services model and harm reduction approach. We employed novel analytical techniques to analyse participants’ service trajectories within this facility to understand how this HIV service environment influences access to, and retention in, HIV care among structurally vulnerable PLHIV who use drugs. Results : Our findings demonstrate that participants’ structural vulnerability shaped their engagement with the HIV care facility that provided access to resources that facilitated retention in HIV care and antiretroviral treatment adherence. Additionally, the integrated service environment helped reduce burdens associated with living in extreme poverty by meeting participants’ subsistence (e.g. food, shelter) needs. Moreover, access to multiple supports created a structured environment in which participants could develop routine service use patterns and have prolonged engagement with supportive care services. Our findings demonstrate that low‐barrier service models can mitigate social and structural barriers to HIV care and complement TasP initiatives for PLHIV who use drugs. Conclusions : These findings highlight the critical role of integrated service models in promoting access to health and support services for structurally vulnerable PLHIV. Complementing structural interventions with integrated service models that are tailored to the needs of structurally vulnerable PLHIV who use drugs will be pursuant to the goals of TasP. 相似文献
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