Showing 1 - 20 of 20 Results for "viral load monitoring"

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Frequent viral load monitoring can result in better health outcomes, including improved adherence and early identification of drug resistance.
Adherence and Support
3 studies Gray IIIb Europe and Canada, Mali, adherence, and France, the United States, treatment, viral load monitoring Burkina Faso, Cameroon, Haiti, India, Malawi, South Africa, Swaziland, Thailand, Uganda, Zimbabwe
Additional efforts are needed in implementing viral load monitoring to increase adherence. A study found that viral load failure was identified a median of 10.4 months earlier through viral load testing as compared to CD4 testing. CD4 testing did not identify almost half of the patients in a large cohort experiencing treatment failure.
Adherence and Support
1 study
Well-functioning laboratory systems are needed to measure viral load via PCR to assess effectiveness of treatment. However, adequate clinical results can also be cost-effective and meet patient needs. A study in sub-Saharan Africa found that more than half of test results for viral load were invalid or inaccurate. A review done in low and middle-income countries showed that lack of routine virologic monitoring in resource limited ART programs led to the development of cross-resistance to the NRTI component of second-line treatment. Even where virological monitoring is available and demonstrates virological failure, delayed switching of patients to alternative antiretroviral therapy regimens occurs.
Provision and Access
1 study
When a couple is serodiscordant or both male and female partners are HIV-positive and wish to conceive, having an undetectable viral load and limiting unprotected sex to peak fertility (with the possible use of pre-exposure prophylaxis) may result in the lowest risk of perinatal transmission. [See also %{s:33}]
Pre-Conception
5 studies Gray IIIb, V pre-exposure prophylaxis, pregnancy, serodiscordant, sexual partners, transmission, treatment Kenya, Saudi Arabia, South Africa, Switzerland, Uganda
Community-based antiretroviral therapy programs may be as effective for adherence as facility-based programs, with lower costs for both patients and services.
Adherence and Support
7 studies Gray I, II, IIIb adherence, community-based care, community-based programs, treatment Botswana, Brazil, Ethiopia, Guyana, Haiti, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Peru, Rwanda, South Africa, Tanzania, Uganda, Zambia
Adherence and Support
Treatment
"I'm 18 years, you are telling me drugs for life?" --Woman living with HIV in Uganda (Hsieh, 2013: 11)Treatment adherence is necessary to continually suppress the virus. Adherence to ART leads to better virological outcomes, prevents disease progression and improves survival (Nachega et al., 2010a; Nachega et al., 2010c). Conversely, inadequate adherence leads to drug resistance, which can then...
Staying Healthy and Reducing Transmission
Treatment
"Me, I try to tell the man that, 'In this house we have been found with this problem. We should accept it. I should not point a finger at you. You, too, should not point a finger at me. Just buy your protection.' And so, little by little what he does now is different from what he did in the past." --Malawi woman living with HIV (Mkandawire-Valhmu and Stephens, 2010: 691)Successfully treated peo...
Home- and community-based antiretroviral treatment may be effective, but attention must be paid to potential effects of stigma and discrimination. [See also %{c:21}]
Provision and Access
5 studies Gray II, IIIa, IIIb community-based care, home-based care, treatment Rwanda, South Africa, Uganda
Provision and Access
Treatment
Antiretroviral therapy has been successfully administered in a range of situations with adherence, retention, and clinical outcomes similar to those achieved in resource-rich countries. Increasing provision and access, grounded in human rights based approaches, across all populations is critical to continuing that success. "I cook scones for my children and do not get tired. I do chores, pound...
Mobile phone text messages from health providers may improve adherence by providing patient support. Note: WHO notes the importance of national regulations to protect the privacy of those receiving text messages (WHO, 2013: 180).
Adherence and Support
6 studies Gray I, II, IIIb adherence, mobile phones, pill counts, treatment Brazil, India, Kenya, Uganda
Screening for and treating STIs syndromically on a continuous, accessible basis improves overall health, and has been associated in one study with reducing the risks of HIV acquisition in a setting with high STI prevalence.
Treating Sexually Transmitted Infections (STIs)
2 studies Gray IIIa, IIIb Eastern, STIs, health facilities, treatment Southern Africa, Tanzania
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 ...
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 ...
Women and Girls
Care and Support
By all estimates, most care and support is provided in the home and women provide two-thirds or more of that care and support (Ogden et al., 2006; Homan et al., 2005b; Akintola, 2006; UN, 2008b; Nyangara et al., 2009b; Surkan et al., 2010). However, this means that one-third of care and support is provided by men, and some have argued that making this more visible can shift gender norms and inc...
Integrating HIV services with family planning, maternal health care or within primary care facilities can increase uptake of HIV testing and treatment and other reproductive health services. [See also %{s:45}]
Structuring Health Services to Meet Women’s Needs
9 studies Gray IIIa, IIIb, IV CD4 counts, HAART, HIV testing, TB, abortion, condom use, contraception, family planning, health facilities, pregnancy, testing, treatment Cambodia, Kenya, Mozambique, Nigeria, South Africa, Tanzania, Zambia
Voluntary Medical Male Circumcision
Prevention for Women
Male circumcision has now been shown in three randomized clinical trials to reduce the risk of HIV acquisition for men by 50-60% (Auvert et al., 2005; Bailey et al., 2007; Gray et al., 2007). Male circumcision at birth as part of postnatal care could result, upon sexual initiation and during his lifetime, in a reduction in the risk of HIV acquisition. Voluntary medical male circumcision (VMMC) ...
Exclusive breastfeeding for the first six months of the infant’s life with a gradual decrease in breastfeeding results in lower rates of HIV transmission to the infant, reduced infant mortality, and improved infant growth compared to mixed feeding or abrupt weaning. Where clean accessible water is not available, breastfeeding after six months reduces infant mortality.
Postpartum
12 studies Gray II, IIIa, IIIb CD4 counts, PMTCT, breastfeeding, breastfeeding PMTCT, formula feeding, infant feeding, mixed feeding, treatment Côte d’Ivoire, Malawi, Nigeria, South Africa, Uganda, Zambia, Zimbabwe
Triple therapy, when used for treatment or prophylaxis through the postpartum period reduces mother-to-child HIV transmission. [See also %{s:45}].
Postpartum
14 studies Gray I, II, IIIa, IIIb, IV, V CD4 counts, HAART, PMTCT, breastfeeding, formula feeding, treatment Botswana, Burkina Faso, Côte d’Ivoire, Ethiopia, India, Kenya, Malawi, Mozambique, Rwanda, South Africa, Southern Africa, Tanzania, Uganda
Decentralization and integration of HIV services may increase adherence and early access to ART. [See also %{c:25}]
Adherence and Support
7 studies Gray I, IIIa Central African Republic, adherence, and Zimbabwe, health facilities, health services, the Democratic Republic of the Congo, the Republic of the Congo, treatment Cambodia, Côte d'Ivoire, Democratic Republic of Congo, Ethiopia, India, Kenya, Lesotho, Malawi, Mozambique, Nigeria, Rwanda, South Africa, Swaziland, Tanzania, Thailand, Uganda, Zambia
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
Given that most HIV transmission occurs through sexual intercourse, it is critical to include a sexual and reproductive health lens in HIV programming. In fact, several European governments have recently revised their international policies, recognizing that HIV/AIDS is a sexual and reproductive health issue (Germain et al., 2009). All women have the right to decide freely and responsibly on t...