Your search found 758 Results

  1. 1
    393580

    Trends in Antiretroviral Therapy Eligibility and Coverage Among Children Aged <15 Years with HIV Infection - 20 PEPFAR-Supported Sub-Saharan African Countries, 2012-2016.

    Burrage A; Patel M; Mirkovic K; Dziuban E; Teferi W; Broyles L; Rivadeneira E

    MMWR. Morbidity and Mortality Weekly Report. 2018 May 18; 67(19):552-555.

    Rapid disease progression and associated opportunistic infections contribute to high mortality rates among children aged <15 years with human immunodeficiency virus (HIV) infection (1). Antiretroviral therapy (ART) has decreased childhood HIV-associated morbidity and mortality rates over the past decade (2). As accumulating evidence revealed lower HIV-associated mortality with early ART initiation, the World Health Organization (WHO) guidelines broadened ART eligibility for children with HIV infection (2). Age at ART initiation for children with HIV infection expanded sequentially in the 2010, 2013, and 2016 WHO guidelines to include children aged <2, <5, and <15 years, respectively, regardless of clinical or immunologic status (3-5). The United States President's Emergency Plan for AIDS Relief (PEPFAR) has supported ART for children with HIV infection since 2003 and, informed by the WHO guidelines and a growing evidence base, PEPFAR-supported countries have adjusted their national pediatric guidelines. To understand the lag between guideline development and implementation, as well as the ART coverage gap, CDC assessed national pediatric HIV guidelines and analyzed Joint United Nations Programme on HIV and AIDS (acquired immunodeficiency syndrome; UNAIDS) data on children aged <15 years with HIV infection and the numbers of these children on ART. Timeliness of WHO pediatric ART guideline adoption varied by country; >50% of children with HIV infection are not receiving ART, underscoring the importance of strengthening case finding and linkage to HIV treatment in pediatric ART programs.
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  2. 2
    391181
    Peer Reviewed

    The continuum of HIV care in South Africa: implications for achieving the second and third UNAIDS 90-90-90 targets.

    Takuva S; Brown AE; Pillay Y; Delpech V; Puren AJ

    AIDS. 2017 Feb 20; 31(4):545-552.

    BACKGROUND: We characterize engagement with HIV care in South Africa in 2012 to identify areas for improvement towards achieving global 90-90-90 targets. METHODS: Over 3.9 million CD4 cell count and 2.7 million viral load measurements reported in 2012 in the public sector were extracted from the national laboratory electronic database. The number of persons living with HIV (PLHIV), number and proportion in HIV care, on antiretroviral therapy (ART) and with viral suppression (viral load <400 copies/ml) were estimated and stratified by sex and age group. Modified Poisson regression approach was used to examine associations between sex, age group and viral suppression among persons on ART. RESULTS: We estimate that among 6511 000 PLHIV in South Africa in 2012, 3300 000 individuals (50.7%) accessed care and 32.9% received ART. Although viral suppression was 73.7% among the treated population in 2012, the overall percentage of persons with viral suppression among all PLHIV was 23.8%. Linkage to HIV care was lower among men (38.5%) than among women (57.2%). Overall, 47.1% of those aged 0-14 years and 47.0% of those aged 15-49 years were linked to care compared with 56.2% among those aged above 50 years. CONCLUSION: Around a quarter of all PLHIV have achieved viral suppression in South Africa. Men and younger persons have poorer linkage to HIV care. Expanding HIV testing, strengthening prompt linkage to care and further expansion of ART are needed for South Africa to reach the 90-90-90 target. Focus on these areas will reduce the transmission of new HIV infections and mortality in the general population.
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  3. 3
    379365
    Peer Reviewed

    From Research to Policy: the WHO with developing guidelines on the potential risk of HIV acquisition and progestogen-only contraception use.

    Han L; Patil E; Kidula N; Gaffield ML; Steyn PS

    Global Health: Science and Practice. 2017 Dec; 5(4):540-546.

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  4. 4
    375764

    Global guidance on criteria and processes for validation: Elimination of mother-to-child transmission of HIV and syphilis. Second edition.

    World Health Organization [WHO]

    Geneva, Switzerland,WHO, 2017. 52 p.

    This second edition of the EMTCT global validation guidance document provides standardized processes and consensus-developed criteria to validate EMTCT of HIV and syphilis, and to recognize high-HIV burden countries that have made significant progress on the path to elimination. The guidance places strong emphasis on country-led accountability, rigorous analysis, intensive programme assessment and multilevel collaboration, including the involvement of communities of women living with HIV. It provides guidance to evaluate the country’s EMTCT programme, the quality and accuracy of its laboratory and data collection mechanisms, as well as its efforts to uphold human rights and equality of women living with HIV, and their involvement in decision-making processes.
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  5. 5
    390476

    Program Implementation of Option B+ at a President's Emergency Plan for AIDS Relief-Supported HIV Clinic Improves Clinical Indicators But Not Retention in Care in Mbarara, Uganda.

    Miller K; Muyindike W; Matthews LT; Kanyesigye M; Siedner MJ

    AIDS Patient Care and STDs. 2017 Aug; 31(8):335-341.

    2013 WHO guidelines for prevention of mother to child transmission recommend combination antiretroviral therapy (ART) for all pregnant women, regardless of CD4 count (Option B/B+). We conducted a retrospective analysis of data from a government-operated HIV clinic in Mbarara, Uganda before and after implementation of Option B+ to assess the impact on retention in care. We limited our analysis to women not on ART at the time of their first reported pregnancy with CD4 count >350. We fit regression models to estimate relationships between calendar period (Option A vs. Option B+) and the primary outcome of interest, retention in care. One thousand and sixty-two women were included in the analysis. Women were more likely to start ART within 6 months of pregnancy in the Option B+ period (68% vs. 7%, p < 0.0001) and had significantly greater increases in CD4 count 1 year after pregnancy (+172 vs. -5 cells, p < 0.001). However, there was no difference in the proportion of women retained in care 1 year after pregnancy (73% vs. 70%, p = 0.34). In models adjusted for age, distance to clinic, marital status, and CD4 count, Option B+ was associated with a nonsignificant 30% increased odds of retention in care at 1 year [adjusted odds ratio (AOR) = 1.30, 95% CI 0.98-1.73, p = 0.06]. After transition to an Option B+ program, pregnant women with CD4 count >350 were more likely to initiate combination therapy; however, interventions to mitigate losses from HIV care during pregnancy are needed to improve the health of women, children, and families.
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  6. 6
    323652

    WHO information note on the use of dual HIV/Syphilis rapid diagnostic tests (RDT).

    World Health Organization [WHO]. Department of Reproductive Health and Research

    Geneva Switzerland, World Health Organization [WHO], 2017. 8 p. (Information Note; WHO/RHR/17.01)

    This information note provides interim advice for countries using or planning to introduce dual HIV/syphilis rapid diagnostic test (RDT) in antenatal services and other testing sites pending forthcoming WHO programmatic guidance, including a WHO recommended testing strategy. This note also emphasizes the need to ensure the quality of HIV and syphilis testing using RDTs, as well as laboratory-based testing, to avoid false positive and false negative HIV and syphilis results
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  7. 7
    389915

    The impact of antiretroviral therapy in resource-limited settings and current HIV therapeutics.

    Kumarasamy N

    Oral Diseases. 2016 Apr; 22 Suppl 1:42-5.

    Four million people of the global total of 35 million with HIV infection are from South-East Asia. ART is currently utilized by 15 million people and has led to a dramatic decline in the mortality rate, including those in low- and middle-income countries. A reduction in sexually transmitted HIV and in comorbidities including tuberculosis has also followed. Current recommendations for the initiation of antiretroviral therapy in people who are HIV+ are essentially to initiate ART irrespective of CD4 cell count and clinical stage. The frequency of HIV testing should be culturally specific and based on the HIV incidence in different key populations but phasing in viral load technology in LMIC is an urgent priority and this needs resources and capacity. With the availability of simplified potent ART regimens, persons with HIV now live longer. The recent WHO treatment guidelines recommending routine HIV testing and earlier initiation of treatment should be the stepping stone for ending the AIDS epidemic and to meet the UNAIDS mission of 90*90*90. (c) 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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  8. 8
    389659

    Implementation effectiveness of revised (post-2010) World Health Organization guidelines on prevention of mother-to-child transmission of HIV using routinely collected data in sub-Saharan Africa: A systematic literature review.

    Gumede-Moyo S; Filteau S; Munthali T; Todd J; Musonda P

    Medicine. 2017 Oct; 96(40):e8055.

    BACKGROUND: To synthesize and evaluate the impact of implementing post-2010 World Health Organization (WHO) prevention of mother-to-child transmission (PMTCT) guidelines on attainment of PMTCT targets. METHODS: Retrospective and prospective cohort study designs that utilized routinely collected data with a focus on provision and utilization of the cascade of PMTCT services were included. The outcomes included the proportion of pregnant women who were tested during their antenatal clinic (ANC) visits; mother-to-child transmission (MTCT) rate; adherence; retention rate; and loss to follow-up (LTFU). RESULTS: Of the 1210 references screened, 45 met the inclusion criteria. The studies originated from 14 countries in sub-Saharan Africa. The highest number of studies originated from Malawi (10) followed by Nigeria and South Africa with 7 studies each. More than half of the studies were on option A while the majority of option B+ studies were conducted in Malawi. These studies indicated a high uptake of human immunodeficiency virus (HIV) testing ranging from 75% in Nigeria to over 96% in Zimbabwe and South Africa. High proportions of CD4 count testing were reported in studies only from South Africa despite that in most of the countries CD4 testing was a prerequisite to access treatment. MTCT rate ranged from 1.1% to 15.1% and it was higher in studies where data were collected in the early days of the WHO 2010 PMTCT guidelines. During the postpartum period, adherence and retention rate decreased, and LTFU increased for both HIV-positive mothers and exposed infants. CONCLUSION: Irrespective of which option was followed, uptake of antenatal HIV testing was high but there was a large drop off along later points in the PMTCT cascade. More research is needed on how to improve later components of the PMTCT cascade, especially of option B+ which is now the norm throughout sub-Saharan Africa.
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  9. 9
    389490
    Peer Reviewed

    A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study.

    Mramba L; Ngari M; Mwangome M; Muchai L; Bauni E; Walker AS; Gibb DM; Fegan G; Berkley JA

    BMJ. 2017 Aug 03; 358:j3423.

    Objectives To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality.Design Growth curve construction and longitudinal cohort study.Setting United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe.Participants The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year.Main outcome measures Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores.Results The new growth curves transitioned smoothly with WHO growth standards at age 5 years. MUAC-for-age z scores of -2 to -3 and less than-3, compared with -2 or more, was associated with hazard ratios for death within one year of 3.63 (95% confidence interval 0.90 to 14.7; P=0.07) and 11.1 (3.40 to 36.0; P<0.001), respectively, among ARROW trial participants; and 2.22 (1.01 to 4.9; P=0.04) and 5.15 (2.49 to 10.7; P<0.001), respectively, among Kenyan children after discharge from hospital. The AUCs for MUAC-for-age and body mass index-for-age z scores for discriminating subsequent mortality were 0.81 (95% confidence interval 0.70 to 0.92) and 0.75 (0.63 to 0.86) in the ARROW trial (absolute difference 0.06, 95% confidence interval -0.032 to 0.16; P=0.2) and 0.73 (0.65 to 0.80) and 0.58 (0.49 to 0.67), respectively, in Kenya (absolute difference in AUC 0.15, 0.07 to 0.23; P=0.0002).Conclusions The MUAC-for-age z score is at least as effective as the body mass index-for-age z score for assessing mortality risks associated with undernutrition among African school aged children and adolescents. MUAC can provide simplified screening and diagnosis within nutrition and HIV programmes, and in research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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  10. 10
    374581

    HIV and young people who sell sex.

    Armstrong A; Baer J; Baggaley R; Verster A; Oyewale T

    Geneva, Switzerland, World Health Organization [WHO], 2015. 44 p.

    Key populations at higher risk of HIV include people who sell sex, men who have sex with men (MSM), transgender people and people who inject drugs. Young people who belong to one or more of these key populations – or who engage in activities associated with these populations – are made especially vulnerable to HIV by factors including widespread discrimination, stigma and violence, combined with the particular vulnerabilities of youth, power imbalances in relationships and, sometimes, alienation from family and friends. These factors increase the risk that they may engage – willingly or not – in behaviours that put them at risk of HIV, such as frequent unprotected sex and the sharing of needles and syringes to inject drugs. This technical brief is one in a series addressing four young key populations. It is intended for policy-makers, donors, service-planners, service-providers and community- led organizations. This brief aims to inform discussions about how best to provide services, programmes and support for young people who sell sex. It offers a concise account of current knowledge concerning the HIV risk and vulnerability of young people who sell sex; the barriers and constraints they face to appropriate services; examples of programmes that may work well in addressing their needs and rights; and approaches and considerations for providing services that both draw upon and build the strengths, competencies and capacities of young people.
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  11. 11
    374580

    HIV and young men who have sex with men.

    Armstrong A; Baer J; Baggaley R; Verster A; Oyewale T

    Geneva, Switzerland, World Health Organization [WHO], 2015. 40 p.

    Key populations at higher risk of HIV include people who sell sex, men who have sex with men (MSM), transgender people and people who inject drugs. Young people who belong to one or more of these key populations – or who engage in activities associated with these populations – are made especially vulnerable to HIV by factors including widespread discrimination, stigma and violence, combined with the particular vulnerabilities of youth, power imbalances in relationships and, sometimes, alienation from family and friends. These factors increase the risk that they may engage – willingly or not – in behaviours that put them at risk of HIV, such as frequent unprotected sex and the sharing of needles and syringes to inject drugs. This technical brief is one in a series addressing four young key populations. It is intended for policy-makers, donors, service-planners, service-providers and community-led organizations. This brief aims to inform discussions about how best to provide health services, programmes and support for young MSM. It offers a concise account of current knowledge concerning the HIV risk and vulnerability of young MSM; the barriers and constraints they face to appropriate services; examples of programmes that may work well in addressing their needs and rights; and approaches and considerations for providing services that both draw upon and build to the strengths, competencies and capacities of young MSM.
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  12. 12
    374579

    HIV and young transgender people.

    Armstrong A; Baer J; Baggaley R; Verster A; Oyewale T

    Geneva, Switzerland, World Health Organization [WHO], 2015. 36 p.

    Key populations at higher risk of HIV include people who sell sex, men who have sex with men (MSM), transgender people and people who inject drugs. Young people who belong to one or more of these key populations – or who engage in activities associated with these populations – are made especially vulnerable to HIV by factors including widespread discrimination, stigma and violence, combined with the particular vulnerabilities of youth, power imbalances in relationships and, sometimes, alienation from family and friends. These factors increase the risk that they may engage – willingly or not – in behaviours that put them at risk of HIV, such as frequent unprotected sex and the sharing of needles and syringes to inject drugs. This brief aims to inform discussions about how best to provide health services, programmes and support for young transgender people. It offers a concise account of current knowledge concerning the HIV risk and vulnerability of young transgender people; the barriers and constraints they face to appropriate services; examples of programmes that may work well in addressing their needs and rights; and approaches and considerations for providing services that both draw upon and build the strengths, competencies and capacities of these young people.
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  13. 13
    374578

    HIV and young people who inject drugs.

    Armstrong A; Baer J; Baggaley R; Verster A; Oyewale T

    Geneva, Switzerland, World Health Organization [WHO], 2015. 34 p.

    Key populations at higher risk of HIV include people who sell sex, men who have sex with men (MSM), transgender people and people who inject drugs. Young people who belong to one or more of these key populations – or who engage in activities associated with these populations – are made especially vulnerable to HIV by factors including widespread discrimination, stigma and violence, combined with the particular vulnerabilities of youth, power imbalances in relationships and, sometimes, alienation from family and friends. These factors increase the risk that they may engage – willingly or not – in behaviours that put them at risk of HIV, such as frequent unprotected sex and the sharing of needles and syringes to inject drugs. This brief aims to inform discussions about how best to provide health services, programmes and support for young people who inject drugs. It offers a concise account of current knowledge concerning the HIV risk and vulnerability of young people who inject drugs; the barriers and constraints they face to appropriate services; examples of programmes that may work well in addressing their needs and rights; and approaches and considerations for providing services that both draw upon and build the strengths, competencies and capacities of young people who inject drugs.
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  14. 14
    374571

    Implementing comprehensive HIV and STI programmes with transgender people: practical guidance for collaborative interventions.

    United Nations Development Programme [UNDP]; IRGT: A Global Network of Transgender Women and HIV; United Nations Population Fund [UNFPA]; University of California, San Francisco. Center of Excellence for Transgender Health; Johns Hopkins Bloomberg School of Public Health; World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; United States Agency for International Development [USAID]

    New York, New York, UNDP, 2016 Apr. 212 p.

    This publication provides guidance to programme designers, implementers, policymakers and decision-makers on how to meaningfully engage adolescents in the AIDS response and in broader health programming. It also demonstrates why adolescents and youth are critical in efforts to end the AIDS epidemic by 2030. The publication additionally highlights what steps should be taken to implement programmes and policies that improve adolescent health outcomes (including for HIV) at the national, regional and global levels.
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  15. 15
    322261

    Hormonal contraception and HIV. Technical update.

    United States. Agency for International Development [USAID]; United States. Centers for Disease Control and Prevention [CDC]; United States. Agency for International Development [USAID]. Office of Population and Reproductive Health

    [Washington, D.C.], United States Agency for International Development [USAID], 2017 Jul. 3 p.

    The purpose of this technical update is to summarize current evidence and the World Health Organization (WHO) revised guidance regarding use of hormonal contraception (HC) by women at high risk of acquiring HIV. On March 2, 2017, WHO issued revised guidance on the use of progestogen-only injectables (norethisterone enanthate [NET-EN] and depot medroxyprogesterone acetate [DMPA], in both intramuscular [IM] and subcutaneous [SC] forms) by women at high risk of HIV acquisition. The recommendation was previously a Category 1 with a clarification, meaning there was no restriction on the use of the progestogen-only injectables, but women at high risk of HIV should be informed that use of those contraceptive methods may or may not increase risk of HIV acquisition. With the revised guidance, progestogen-only injectables are now classified as Category 2 for women at high risk of HIV acquisition. (excerpt)
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  16. 16
    374444

    Hormonal contraception: recommendations for women at high risk of HIV.

    International Planned Parenthood Federation [IPPF]

    [London, United Kingdom, IPPF], 2017 Jun. 3 p.

    The World Health Organization (WHO) issued revised guidance on the eligibility criteria for hormonal contraceptive use among women at high risk of acquiring HIV in March 2017. This update is critically important for women’s health, particularly in sub-Saharan Africa where HIV prevalence is high and injectable contraception is widely used.
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  17. 17
    375676

    Aligning incentives, accerlerating impact. Next generation financing models for global health.

    Silverman R; Over M; Bauhoff S

    Washington, D.C., Center for Global Development, 2015. 68 p.

    Founded in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is one of the world’s largest multilateral health funders, disbursing $3-$4 billion a year across 100-plus countries. Many of these countries rely on Global Fund monies to finance their respective disease responses -- and for their citizens, the efficient and effective use of Global Fund monies can be the difference between life and death. Many researchers and policymakers have hypothesized that models tying grant payments to achieved and verified results -- referred to in this report as next generation financing models -- offer an opportunity for the Global Fund to push forward its strategic interests and accelerate the impact of its investments. Free from year-to-year disbursement pressure (like government agencies) and rigid allocation policies (like the World Bank’s International Development Association), the Global Fund is also uniquely equipped to push forward innovative financing models. But despite interest, the how of new grant designs remains a challenge. Realizing their potential requires technical know-how and careful, strategic decisionmaking that responds to specific country and epidemiological contexts -- all with little evidence or experience to guide the way. This report thus addresses the how of next generation financing models -- that is, the concrete steps needed to change the basis of payment from expenses to something else: outputs, outcomes, or impact. (Excerpts)
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  18. 18
    375674

    Designing contracts for the Global Fund: Lessons from the theory of incentives.

    Wren-Lewis L

    Washington, D.C., Center for Global Development, 2016 Feb. 38 p. (Center for Global Development Working Paper 425)

    This paper uses contract theory to suggest simple contract designs that could be used by the Global Fund. Using a basic model of procurement, we lay out five alternative options and consider when each is likely to be most appropriate. The rest of the paper then discusses how one can build a real-world contract from these theoretical foundations, and how these contracts should be adapted to different contexts when the basic assumptions do not hold. Finally, we provide a synthesis of these various results with the aim of guiding policy makers as to when and how ‘results-based’ incentive contracts can be used in practice.
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  19. 19
    388052
    Peer Reviewed

    Elimination of mother-to-child transmission of HIV and Syphilis (EMTCT): Process, progress, and program integration.

    Taylor M; Newman L; Ishikawa N; Laverty M; Hayashi C; Ghidinelli M; Pendse R; Khotenashvili L; Essajee S

    PLoS Medicine. 2017 Jun; 14(6):e1002329.

    Melanie Taylor and colleagues discuss progress towards eliminating vertical transmission of HIV and syphilis.
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  20. 20
    375554

    Reinvigorating the AIDS response to catalyse sustainable development and United Nations reform. Report of the Secretary-General.

    United Nations. Secretary-General

    [New York, New York], United Nations, General Assembly, 2017 Apr 7. 25 p. (A/71/864)

    Bold global commitments, shared financial responsibility and a people-centred approach based on the principles of equity have yielded shared success in the AIDS response. The 90-90-90 initiative has guided a dramatic expansion of antiretroviral treatment and greatly reduced AIDS-related deaths, while also contributing to a reduction in new HIV infections. A global plan to eliminate mother-to-child transmission of HIV has more than halved the number of new HIV infections among children. The AIDS response has made an important contribution to the demographic dividend of Africa, its recent economic growth and the emerging vision of Africa as a continent of hope, promise and vast potential. Global optimism has fuelled the highest ambition within the 2030 Agenda for Sustainable Development: ending the AIDS epidemic by 2030. A fast-track response to reach this target has been agreed by the United Nations General Assembly within the 2016 Political Declaration on HIV and AIDS: On the Fast Track to Accelerating the Fight against HIV and to Ending the AIDS Epidemic by 2030. Achieving our aims on AIDS is interlinked with and embedded within the broader 2030 Agenda: both are grounded in equity, human rights and a promise to leave no one behind. Hard-fought gains must not be lost. An international architecture that has stimulated leadership, provided direction, mobilized unprecedented levels of financial resources and saved millions of lives must not be taken for granted. Closing the investment gap of $7 billion per year and ensuring that financial resources are wisely used will avert tens of millions of new HIV infections and AIDS-related deaths, a return on investment that is nothing short of priceless. (Excerpts)
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  21. 21
    374277

    When will sub-Saharan Africa adopt HIV treatment for all?

    Gupta S; Granich R

    Southern African Journal of HIV Medicine. 2016; 17(1):[6] p.

    Background: The World Health Organization (WHO) HIV treatment guidelines have been used by various countries to revise their national guidelines. Our study discusses the national policy response to the HIV epidemic in sub-Saharan Africa and quantifies delays in adopting the WHO guidelines published in 2009, 2013 and 2015. Methods: From the Internet, health authorities and experts, and community members, we collected 59 published HIV guidelines from 33 countries in the sub-Saharan African region, and abstracted dates of publication and antiretroviral therapy (ART) eligibility criteria. For these 33 countries, representing 97% regional HIV burden in 2015, the number of months taken to adopt the WHO 2009, 2013 and/or 2015 guidelines were calculated to determine the average delay in months needed to publish revised national guidelines. Findings: Of the 33 countries, 3 (6% regional burden) are recommending ART according to the WHO 2015 guidelines (irrespective of CD4 count); 19 (65% regional burden) are recommending ART according to the WHO 2013 guidelines (CD4 count = 500 cells/mm3); and 11 (26% regional burden) according to the WHO 2009 guidelines (CD4 count = 350 cells/mm3). The average time lag to WHO 2009 guidelines adoption in 33 countries was 24 (range 3–56) months. The 22 that have adopted the WHO 2013 guidelines took an average of 10 (range 0–36) months, whilst the three countries that adopted the WHO 2015 guidelines took an average of 8 (range 7–9) months. Conclusion: There is an urgent need to shorten the time lag in adopting and implementing the new WHO guidelines recommending ‘treatment for all’ to achieve the 90-90-90 targets.
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  22. 22
    375395

    A tool for strengthening gender-sensitive national HIV and Sexual and Reproductive Health (SRH) monitoring and evaluation systems.

    World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, WHO, 2016. 126 p.

    WHO and UNAIDS have released a new tool for strengthening gender-sensitive national HIV and sexual and reproductive health (SRH) monitoring and evaluation systems. The tool provides step-by-step guidance to strategic information specialists and monitoring and evaluation officers of HIV and SRH programmes on how to ask the right questions in order to uncover gender inequalities and their influence on health; identify and select gender-sensitive indicators; conduct gender-analysis of SRH and HIV data; and strengthen monitoring and evaluation systems to enable appropriate data collection and gender analysis. The tool has been used by nearly 30 country teams of strategic information specialists, civil society and HIV programme implementers to analyse their own SRH and HIV data from a gender equality perspective. It can be used for training monitoring and evaluation specialists as well as a resource guide for SRH and HIV programmes to develop gender profiles of their SRH and HIV situation. “Know your epidemic, know your response” has been the cornerstone of the HIV response. This tool supports this approach by helping identify inequities and underlying drivers and hence, improve evidence-informed SRH and HIV programmes for all, but particularly for women and girls.
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  23. 23
    375370

    Hormonal contraceptive eligibility for women at high risk of HIV. Guidance statement. Recommendations concerning the use of hormonal contraceptive methods by women at high risk of HIV.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2017. 20 p. (WHO/RHR/17.04)

    The World Health Organization (WHO) convened a technical consultation during 1-2 December 2016 to review new evidence on the risk of HIV acquisition with the use of hormonal contraception. The issue was recognized as a critical one, particularly for sub-Saharan Africa, where women have a high lifetime risk of acquiring HIV, hormonal contraceptives constitute a significant component of the contraceptive method mix and unintended pregnancy is a common threat to the well-being and lives of women and girls. A wide range of stakeholders were present at this meeting, and serving on the Guideline Development Group (GDG) was global representation from experts in family planning and HIV, representatives from affected populations, clinicians, epidemiologists, researchers, programme managers, policy-makers and guideline methodologists. The GDG considered the following factors in making their determination for each contraceptive method: quality of the evidence (GRADE profile); values and preferences of contraceptive users and health care providers; balance of benefits and harms; priority of the problem; equity and human rights; acceptability; and feasibility. Through consensus, the GDG arrived at new recommendations for progestogen-only injectables. The recommendations for use of progestogen-only injectables among women at high risk of HIV changed from category 1 to category 2, with an accompanying clarification, in the Medical eligibility criteria for contraceptive use (MEC). Recommendations for all other methods of hormonal contraception remained unchanged. (Excerpts)
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  24. 24
    378771

    [Quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou of Henan province].

    Ma LP; Xu P; Sun DY; Li N; Yang WJ; Zhang L; Bai YJ; Ju LH; He HJ; Chen WY; Lyu P

    Zhonghua Yu Fang Yi Xue Za Zhi [Chinese Journal of Preventive Medicine]. 2016 Apr; 50(4):339-45.

    OBJECTIVE: To investigate the quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou city of Henan province. METHODS: During January to May in 2015, by the convenience sample, World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF) (Chinese version) and a self-edited questionnaire were used to investigate 1 251 HIV/AIDS patients who were confirmed with HIV positive by local CDC, registered in"HIV serodiscordant family" and agreed to participate in a face-to-face interview with above 18 year-old based on the local CDC , township hospitals and village clinics of 9 counties and 1 district of Zhoukou city, excluding the HIV/AIDS patients who were in divorce, death by one side, unknowing about his HIV status, with mental illness and disturbance of consciousness, incorrectly understanding the content of the questionnaire, and reluctant to participate in this study. The scores of quality of life of physical, psychological, social relations, and environmental domain were calculated. The related factors of the scores of different domains were analyzed by Multiple Two Classification Unconditioned Logistic Regression. RESULTS: The scores of investigation objects in the physical, psychological, social relations, and environmental domain were 12.00+/- 2.02, 12.07 +/- 2.07, 11.87 +/- 1.99, and 11.09 +/- 1.84, respectively. The multiple Unconditioned Logistic Regression analysis indicated that age <40 years, on ART and no other sickness in last two weeks were beneficial factors associated with physical domain with OR (95%CI): 0.61 (0.35-1.06), 0.52 (0.30-0.90), and 1.66 (1.09-2.52), respectively. The possibility of no poverty and no other sickness in last two weeks increased to 0.15(0.09-0.26) and 1.57(1.06-2.33) times of those who was in poverty and with other sickness in last two weeks in physical domain. The possibility of participants who were below 40 years old and with children increased to 0.58 (0.34-0.98) and 0.37 (0.23-0.57) times of who were above 40 years old and without children in psychological domain. The factors of with AIDS related symptoms, no children and with other sickness in last two week were found to be significantly associated with environmental domain with OR (95%CI): 0.65 (0.48-0.88), 0.66 (0.51-0.85), and 0.65 (0.51-0.84), respectively . CONCLUSION: The scores of every domain of quality of life in HIV serodiscordant couples of Zhoukou city were good. Age, whether having AIDS related symptoms, whether to accept ART , children, status of poverty, and whether suffering from other diseases in last two weeks were the main factors associated with the quality of life.
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  25. 25
    375275

    For every child, end AIDS -- Seventh stocktaking report, 2016.

    UNICEF

    New York, New York, UNICEF, 2016 Dec. 92 p.

    Despite remarkable achievements in the prevention and treatment of HIV, this report finds that progress has been uneven globally. In 2015, more than half of the world’s new infections (1.1 million out of 2.1 million) were among women, children and adolescents, and nearly 2 million adolescents aged 10-19 were living with HIV. In sub-Saharan Africa, the region most impacted by HIV, three in four new infections in 15-19-year-olds were among girls. The report proposes strategies for preventing HIV among women, children and adolescents who have been left behind, and treating those who are living with HIV.
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