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Showing 1 - 20 of 236 Results for "treatment"

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Treatment
Antiretroviral therapy has transformed HIV to a chronic - though still incurable - virus requiring ongoing therapy and strict adherence to treatment. For the most part, virally suppressed people living with HIV today have no difference in life expectancy than demographically similar HIV-negative individuals (Sabin, 2013 cited in Justice and Falutz, 2014; Maman et al. 2012a). This section does ...
Treatment as Prevention
Prevention for Women
Antiretroviral medication has been successfully used in a number of ways: first and foremost to treat those with high viral load and diminishing CD4 counts; secondly to prevent vertical transmission of HIV from pregnant and breastfeeding women to their infants; third, as a prophylactic for those who have been exposed to HIV occupationally or through sexual assault (post-exposure prophylaxis, PE...
Antenatal Care - Treatment
Safe Motherhood and Prevention of Vertical Transmission
Antiretroviral treatment (ART) for women living with HIV is vital to ensuring safe motherhood and reducing vertical transmission. But not all pregnant women access treatment. For women in high-income countries where access to triple therapy during pregnancy has been the standard of care and is near universal, rates of vertical HIV transmission are as low as 0.4%, for example, in Canada (Forbes ...
ARV therapy can reduce (but does not eliminate) the risk of HIV transmission and is an additional prevention strategy. [See %{s:33}]
Treatment as Prevention
1 study
Providing antiretroviral treatment to people living with HIV can increase HIV prevention behaviors, including condom use. [See %{s:33}]
Treatment as Prevention
1 study
Intensified efforts are needed to increase access to treatment, condom use and reduce multiple partnerships by people who know their HIV-positive status or who are on ARV treatment, including young people. [See %{s:29} and %{s:33}]
Treatment as Prevention
1 study
HIV testing must be linked to access to treatment.
Antenatal Care - Testing and Counseling
1 study
Strengthened post-test counseling for those who test HIV positive must explain who is eligible for treatment; the importance of treatment and reducing transmission; and where to access treatment. A study found that women who tested positive did not know about treatment nor where to go to access treatment.
HIV Testing and Counseling for Women
1 study
Peer counseling by mother mentors may improve treatment adherence among pregnant women living with HIV.
Antenatal Care - Treatment
6 studies Gray II, IIIa, IIIb, IV, V adherence, peer support, pregnancy, treatment Ethiopia, Kenya, Malawi, Namibia, Nigeria, South Africa, Uganda
Interventions are needed to sustain viral suppression and reduce loss to follow up once a woman has initiated Option B+, including affordable means of monitoring virological response and effective adherence counseling. Research is needed on how long is optimal to provide care within maternal health systems or when to transfer cART provision outside of maternal health systems. Compared to people who started cART for their own health, a study found that women who started cART while pregnant were 5 times less likely to return to the clinics after the initial visit. Women who started cART while breastfeeding were twice as likely to miss their first follow up appointment. On average, 17% of pregnant women who started ART under Option B+ dropped out of care in the first six months of ART and 22% dropped out within one year (Tenhathi et al., 2014). Systems are rarely in place to track mothers six weeks post-partum (Psaros et al., 2015; Waiswa, 2016). A survey found that ART retention was greatest in those facilities where newly diagnosed pregnant women living with HIV were referred from ANC to the ART clinic in the same facility for initiation and follow up or were referred to facilities serving as ART referral sites that did not provide ANC (van Lettow et al., 2014). A review noted that women found challenges in accessing cART either through maternal care systems, postpartum or through HIV care. Input from pregnant and postpartum women living with HIV is needed
Antenatal Care - Treatment
1 study
Strategies need to be identified to empower women to create demand for improved maternal health services and challenge violations of their rights in facility-based childbirth. This is a particularly acute need for women living with HIV. Studies show that HIV-related stigma may reduce the likelihood of delivering in a health facility
Antenatal Care - Treatment
1 study
Ongoing surveillance is needed to assess the impact of cART on infants (both HIV-negative and HIV-positive) exposed in utero and during breastfeeding. A recent US study had encouraging results that among ARV-exposed uninfected children, no learning issues were noted (Nozyce et al., 2014) and another US-based study found no increased risk for infants exposed to ART (Phiri et al., 2014). A pilot ART registry in Africa has been launched
Antenatal Care - Treatment
1 study
Monitoring for drug resistance in low- and middle-income countries is needed during Option B+ scale up. Studies are finding drug resistance among women who are initiating cART or who have initiated cART
Antenatal Care - Treatment
1 study
Efforts are needed to effectively implement Option B+ in non-prejudicial ways. Women who were sex workers reported being denied care until delivery. Women who were not accompanied by husbands were denied any health services during pregnancy. A sign on health centers read: “Notice: all pregnant women are supposed to come with their husbands/partners at their first visit. You will not be given services without implementing this” (Beckham et al., 2015: 66).
Antenatal Care - Treatment
1 study
PMTCT-Plus (family-focused) HIV care can increase the numbers of women and their partners who access treatment and remain adherent. Note: This should not be implemented in any way that prejudices women who do not want to disclose to partners (see overview).
Antenatal Care - Treatment
4 studies Gray IIIa, IIIb PMTCT Plus, PMTCT-Plus, pregnancy, treatment Africa, Botswana, Côte d’Ivoire, South Africa, Tanzania, Uganda, Zambia
Interventions are needed for male involvement that do not such reinforce harmful gender norms or increase risk for violence, stigma or discrimination. “Evidence for effectiveness of male involvement in PMTCT programs is scant” (Beckham et al., 2015: 67). One study only evaluated male involvement as accompanying their pregnant partner to ANC care with no HIV related outcomes listed and tasking the woman to require her male partner to come to ANC (Nyondo et al., 2015). Most approaches only reach men through their pregnant spouse, with no services for men beyond HIV testing and use men as an instrument solely to increase access to services by women. Men have been denied involvement in antenatal care, birth and delivery even if the couple so chooses.
Antenatal Care - Treatment
1 study
Integrating ARV therapy into antenatal care, rather than referring women separately for HIV treatment, can reduce time to treatment and increase adherence for pregnant women living with HIV. [See also %{c:25}] Note: A review found that no one model of care fully addressed all barriers for women, but the most effective models focused on the period of transition between pregnancy and postpartum (Colvin et al., 2014).
Antenatal Care - Treatment
9 studies Gray IIIa, IIIb, IV Zambi, antenatal care, pregnancy, treatment Kenya, Mozambique, Rwanda, South Africa, Zambia
Additional support for pregnant women living with HIV who face violence is needed, including establishing proper mechanisms for seeking redress, along with more research on mental health and maternal morbidity among women living with HIV.
Antenatal Care - Treatment
1 study
National scale-up of cART in pregnancy improves maternal and infant outcomes.
Antenatal Care - Treatment
4 studies Gray IIIb Jamaica, pregnancy, scale up, treatment Malawi, South Africa, Ukraine
Women and men need accurate information on vertical transmission, treatment adherence strategies, the importance of their viral load and the low risk of vertical transmission if virally suppressed. Adherence has been challenging for women living with HIV postpartum, even for those initiating ART during pregnancy at CD4 counts under 350, with adequate adherence dropping from 75.7% during pregnancy to 53% postpartum globally (Nachega et al., 2012 cited in Coutsoudis et al., 2013). Knowledge of HIV and vertical transmission has shown to be correlated with increased initiation, adherence and retention for pregnant women living with HIV.
Antenatal Care - Treatment
1 study