Browsing by Title
HIV drug combination: safety review of clinical trial data
( 2010 )
HIV drug resistance early warning indicators in cohorts of individuals starting antiretroviral therapy between 2004 and 2009: World Health Organization global report from 50 countries
Kelley, Karen F; Ravasi, Giovanni; Hong, Steven Y; McMahon, James H; Saadani, Ahmed; Bertagnolio, Silvia; Jordan, Michael R; Bennett, Diane E ( 2012-05-01 )
The World Health Organization developed a set of human immunodeficiency virus drug resistance (HIVDR) early warning indicators (EWIs) to assess antiretroviral therapy clinic and program factors associated with HIVDR. EWIs are monitored by abstracting data routinely recorded in clinical records, and the results enable clinics and program managers to identify problems that should be addressed to minimize preventable emergence of HIVDR in clinic populations. As of June 2011, 50 countries monitored EWIs, covering 131 686 patients initiating antiretroviral treatment between 2004 and 2009 at 2107 clinics. HIVDR prevention is associated with patient care (appropriate prescribing and patient monitoring), patient behavior (adherence), and clinic/program management efforts to reduce treatment interruptions (follow up, retention on first-line ART, procurement and supply management of antiretroviral drugs). EWIs measure these factors and the results have been used to optimize patient and population treatment outcomes.
HIV drug resistance early warning indicators in namibia with updated World Health Organization guidance
Tjituka, Francina; Desta, Tiruneh; Hong, Steven Y; Tang, Alice M; Mwinga, Samson; DeKlerk, Michael; Penney, Scott; Jordan, Michael R; Sumbi, Victor; Jonas, Anna ( 2014-07-02 )
BACKGROUND: In response to concerns about the emergence of HIV drug resistance (HIVDR), the World Health Organization (WHO) has developed a comprehensive set of early warning indicators (EWIs) to monitor HIV drug resistance and good programme practice at antiretroviral therapy (ART) sites. METHODS: In 2012, Namibia utilized the updated WHO EWI guidance and abstracted data from adult and pediatric patients from 50 ART sites for the following EWIs: 1. On-time Pill Pick-up, 2. Retention in Care, 3. Pharmacy Stock-outs, 4. Dispensing Practices, and 5. Virological Suppression. RESULTS: Data for EWIs one through four were abstracted and validated. EWI 5--Virological Suppression was not included due to poor data entry at many sites. On-time Pill Pick-up national estimate was 87.9% (87.2-88.7) of patients picking up pills on time for adults and 90.0% (88.9-90.9) picking up pills on time for pediatrics. Retention in Care national estimate was 82% of patients retained on ART after 12 months for adults and 83% for pediatrics. Pharmacy Stock-outs national estimate was 99% of months without a stock-out for adults and 97% for pediatrics. Dispensing Practices national estimate was 0.01% (0.003-0.064) of patients dispensed mono- or dual-therapy for adults and 0.25% (0.092-0.653) for pediatrics. CONCLUSIONS: The successful 2012 EWI exercise provides Namibia a solid evidence base, which can be used to make national statements about programmatic functioning and possible HIVDR. This evidence base will serve to contextualize results from Namibia's surveys of HIVDR, which involves genotype testing. EWI abstraction has prompted the national program and its counterparts to engage sites in dialogue regarding the need to strengthen adherence and retention of patients on ART. The EWI collection process and EWI results will serve to optimize patient care and support Namibia in making evidence-based recommendations and take action to minimize the emergence of preventable HIVDR.
HIV drug resistance prevention, surveillance and monitoring in the Western Pacific Region
World Health Organization. Regional Office for the Western Pacific ( 2009 )
The HIV drug resistance report - 2012
World Health Organization ( 2012 )
HIV drug resistance surveillance guidance: 2015 update
World Health Organization ( 2016 )
HIV due to female sex work: regional and global estimates
Driscoll, Tim; Wolf, Jennyfer; Degenhardt, Louisa; Neira, Maria; Prüss-Ustün, Annette; Calleja, Jesus Maria Garcia ( 2013-05-23 )
INTRODUCTION: Female sex workers (FSWs) are at high risk of HIV infection. Our objective was to determine the proportion of HIV prevalence in the general female adult population that is attributable to the occupational exposure of female sex work, due to unprotected sexual intercourse. METHODS: Population attributable fractions of HIV prevalence due to female sex work were estimated for 2011. A systematic search was conducted to retrieve required input data from available sources. Data gaps of HIV prevalence in FSWs for 2011 were filled using multilevel modeling and multivariate linear regression. The fraction of HIV attributable to female sex work was estimated as the excess HIV burden in FSWs deducting the HIV burden in FSWs due to injecting drug use. RESULTS: An estimated fifteen percent of HIV in the general female adult population is attributable to (unsafe) female sex work. The region with the highest attributable fraction is Sub Saharan Africa, but the burden is also substantial for the Caribbean, Latin America and South and Southeast Asia. We estimate 106,000 deaths from HIV are a result of female sex work globally, 98,000 of which occur in Sub-Saharan Africa. If HIV prevalence in other population groups originating from sexual contact with FSWs had been considered, the overall attributable burden would probably be much larger. DISCUSSION: Female sex work is an important contributor to HIV transmission and the global HIV burden. Effective HIV prevention measures exist and have been successfully targeted at key populations in many settings. These must be scaled up. CONCLUSION: FSWs suffer from high HIV burden and are a crucial core population for HIV transmission. Surveillance, prevention and treatment of HIV in FSWs should benefit both this often neglected vulnerable group and the general population.
HIV early diagnosis/treatment: implementation science research to strengthen retention in the cascade
World Health Organization, Regional Office for South-East Asia ( 2015-07 )
Implementation Science Research helps countries tackle HIV. Most countries in the Region are moving towards early initiation of treatment for people living with HIV, however there are major challenges including early diagnosis and linkages to care, reaching key populations, developing robust monitoring and evaluation systems and identifying efficient service delivery models. Implementation science research which translates research findings into real world public health systems can help overcome these challenges. To strengthen the role of implementation science research in HIV response, the WHO Regional Offices for South-East Asia and the Western Pacific jointly organized an expert consultation on implementation science research on 9-11 December 2014 in New Delhi, India. Participants discussed ongoing research projects and generated key research questions that could be answered in future projects to inform policies and programmes.
HIV Epidemic in Asia: Implications for HIV Vaccine and Other Prevention Trials
Chang, David; Shao, Yiming; Lo, Ying-Ru; Kim, Jerome H; Phanuphak, Nittaya; O'Connell, Robert J; Solomon, Sunil Suhas; Tovanabutra, Sodsai; Excler, Jean Louis ( 2015-06-24 )
An overall decrease of HIV prevalence is now observed in several key Asian countries due to effective prevention programs. The decrease in HIV prevalence and incidence may further improve with the scale-up of combination prevention interventions. The implementation of future prevention trials then faces important challenges. The opportunity to identify heterosexual populations at high risk such as female sex workers may rapidly wane. With unabating HIV epidemics among men who have sex with men (MSM) and transgender (TG) populations, an effective vaccine would likely be the only option to turn the epidemic. It is more likely that efficacy trials will occur among MSM and TG because their higher HIV incidence permits smaller and less costly trials. The constantly evolving patterns of HIV-1 diversity in the region suggest close monitoring of the molecular HIV epidemic in potential target populations for HIV vaccine efficacy trials. CRF01_AE remains predominant in southeast Asian countries and MSM populations in China. This relatively steady pattern is conducive to regional efficacy trials, and as efficacy warrants, to regional licensure. While vaccines inducing nonneutralizing antibodies have promise against HIV acquisition, vaccines designed to induce broadly neutralizing antibodies and cell-mediated immune responses of greater breadth and depth in the mucosal compartments should be considered for testing in MSM and TG. The rationale and design of efficacy trials of combination prevention modalities such as HIV vaccine and preexposure prophylaxis (PrEP) remain hypothetical, require high adherence to PrEP, are more costly, and present new regulatory challenges. The prioritization of prevention interventions should be driven by the HIV epidemic and decided by the country-specific health and regulatory authorities. Modeling the impact and cost-benefit may help this decision process.
HIV epidemic in Punjab, India : time trends over a decade / S. Sehgal
Sehgal, S ( 1998 )
HIV financing status in selected countries of the Western Pacific Region (2009-2015)
World Health Organization. Regional Office for the Western Pacific ( 2016 )
HIV in pregnancy : a review
World Health Organization. Dept. of Reproductive Health and Research; UNAIDS ( 1999 )
HIV in prisons: a reader with particular relevance to the newly independent states/ edited by Paola Bollini
Bollini, Paola; World Health Organization. Regional Office for Europe ( 2001 )
HIV in the WHO African Region Progress towards achieving Universal Access to priority health sector interventions: 2013 UPDATE
World Health Organization. Regional Office for Africa ( 2013 )
HIV Incidence and Spatial Clustering in a Rural Area of Southern Mozambique
De Lazzari, Elisa; Aponte, John J; Pedro, Elpidia N; Augusto, Orvalho J; Menendez, Clara; González, Raquel; Naniche, Denise; Sacoor, Charfudin; Macete, Eusébio; Alonso, Pedro L; Pierrat, Charlotte; Munguambe, Khátia ( 2015-07-06 )
Monitoring the HIV epidemic in a defined population is critical for planning treatment and preventive strategies. This is especially important in sub-Saharan Africa, which harbours the highest burden of the disease.To estimate HIV incidence in adults aged 18-47 years old and to investigate spatial variations of HIV prevalence in Manhiça, a semi-rural area of southern Mozambique.Two cross-sectional community-based surveys were conducted in 2010 and 2012 to determine HIV prevalence. Individual participants were randomly selected from the demographic surveillance system in place in the area and voluntary HIV counselling and testing was offered at the household level. HIV incidence was calculated using prevalence estimates from the two sero-surveys. Each participant's household was geocoded using a global information system. The Spatial Scan Statistics programme was used to identify areas with disproportionate excess in HIV prevalence.A total of 1511 adults were tested. The estimated HIV prevalence in the community was 39.9% in 2010 and 39.7% in 2012. The overall HIV incidence was 3.6 new infections per 100 person-years at risk (PYAR) [95CI 1.56; 7.88], assuming stable epidemic conditions, and tended to be higher in women (4.9/100 PYAR [95CI 1.74; 11.85]) than in men (3.2/PYAR [95CI 1.36; 9.92]). One cluster with significant excess HIV prevalence was identified at the same geographic location in both surveys. This cluster had an HIV prevalence of 79.0% in 2010 and 52.3% in 2012.The findings of these first individually-randomised community-HIV sero-surveys conducted in Mozambique reinforce the need to combine HIV incidence estimates and research on micro geographical infection patterns to guide and consolidate effective prevention strategies.
HIV infection and AIDS : guidelines for nursing care
World Health Organization. Regional Office for the Western Pacific ( 1993 )
HIV infection and related risk behaviours among female sex workers in greater Cairo, Egypt
Kabbash, I.A.; Abdul-Rahman, I.; Shehata, Y.A.; Omar, A.A.R. ( 2012 )
Although illegal in Egypt, prostitution exists. The prevalence of HIV infection among female sex workers [FSWs] in Cairo is not precisely known. This cross-sectional study investigated the high-risk behaviour for HIV infection and HIV prevalence among FSWs in greater Cairo. A total of 431 FSWs were interviewed about their sexual history with paid and unpaid partners, condom use and risky behaviour for HIV infection; all were tested for HIV. Use of alcohol and drugs was reported by 39.9% and 49.0% of the women respectively; 37.6% only used such substances while with a client. Male condoms were known by 72.6% but their use in the previous month was low [32.8%] and only 22.4% had used one with their last client. The main reasons for not using condoms were not thinking of it [40.6%] and client refusal [20.5%). All the women tested negative for HIV infection. The high-risk behaviour of many FSWs necessitates intervention programmes to reduce their risk of HIV infection
HIV infection and routine childhood immunization : a review / C. J. Clements, C. F. von Reyn & J. M. Mann
Clements, C. John; Reyn, C. F. von; Mann, Jonathan M ( 1987 )
HIV infection in patients with tuberculosis in Baghdad [1996-1998]
Abdul Abbas, A.J.; Al Delami, A.M.; Yousif, T.K. ( 2000 )
A three-staged prospective study involving 430 patients with tuberculosis was conducted at the Tuberculosis Institute, Baghdad during 1996-98. Of the 430 patients, 270 were males, 370 patients were diagnosed as pulmonary tuberculosis and 60 patients had extrapulmonary tuberculosis. Considering some risk factors for human immunodeficiency virus [HIV] infection, 11 patients had tattoos, 13 were prisoners and 5 were barbers. All the patients were tested for HIV infection and all were negative