Retention Throughout the HIV Care and Treatment Cascade: From Diagnosis to Antiretroviral Treatment of Adults and Children Living with HIV—Haiti, 1985–2015
| Autor: | Duval N, Deyde, Chris Delcher, Mayer Antoine, Jean Wysler Domercant, David W. Lowrance, Mark Griswold, Kesner François, Andrew F. Auld, Valerie Pelletier, Desir Y, Joseph N, Ray W. Shiraishi, Patrice Joseph Ya, Ermane Robin, Van Onacker Jd, Jacob Dee, Gracia Desforges |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine Pediatrics medicine.medical_specialty Adolescent Anti-HIV Agents Art initiation Human immunodeficiency virus (HIV) HIV Infections Newly diagnosed medicine.disease_cause Young Adult 03 medical and health sciences 0302 clinical medicine Antiretroviral Therapy Highly Active Virology medicine Antiretroviral treatment Humans Cumulative incidence 030212 general & internal medicine Disease management (health) Young adult Child business.industry Infant Newborn Disease Management Infant Articles 030112 virology Antiretroviral therapy Haiti CD4 Lymphocyte Count Infectious Diseases Child Preschool Patient Compliance Female Parasitology business |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.17-0116 |
| Popis: | Monitoring retention of people living with HIV (PLHIV) in the HIV care and treatment cascade is essential to guide program strategy and evaluate progress toward globally-endorsed 90–90–90 targets (i.e., 90% of PLHIV diagnosed, 81% on sustained antiretroviral therapy (ART), and 73% virally suppressed). We describe national retention from diagnosis throughout the cascade for patients receiving HIV services in Haiti during 1985–2015, with a focus on those receiving HIV services during 2008–2015. Among the 266,256 newly diagnosed PLHIV during 1985–2015, 49% were linked-to-care, 30% started ART, and 18% were retained on ART by the time of database closure. Similarly, among the 192,187 newly diagnosed HIV-positive patients during 2008–2015, 50% were linked to care, 31% started ART, and 19% were retained on ART by the time of database closure. Most patients (90–92%) at all cascade steps were adults (≥ 15 years old), among whom the majority (60–61%) were female. During 2008–2015, outcomes varied significantly across 42 administrative districts (arrondissements) of residence; cumulative linkage-to-care ranged from 23% to 69%, cumulative ART initiation among care enrollees ranged from 2% to 80%, and cumulative ART retention among ART enrollees ranged from 30% to 88%. Compared with adults, children had lower cumulative incidence of ART initiation among care enrollees (64% versus 47%) and lower cumulative retention among ART enrollees (64% versus 50%). Cumulative linkage-to-care was low and should be prioritized for improvement. Variations in outcomes by arrondissement and between adults and children require further investigation and programmatic response. |
| Databáze: | OpenAIRE |
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