Chronic distress and the vulnerable host: a new target for HIV treatment and prevention?

2021 ◽

Vol 20 ◽

pp. 232595822110090

Author(s):

Kimberly K. Scarsi ◽

Susan Swindells

Keyword(s):

Medication Adherence ◽

Antiretroviral Therapy ◽

Hiv Treatment ◽

Virologic Suppression ◽

Social Barriers ◽

Treatment And Prevention ◽

Undetectable Viremia ◽

Long Acting ◽

Available Information ◽

Living With Hiv

As with other chronic conditions, adherence to daily medications remains a challenge for many individuals living with HIV due to structural, behavioral, and social barriers. Unfortunately, high levels of adherence to antiretroviral therapy are required to maintain virologic suppression. Alternative approaches are being explored to decrease the burden of daily pill administration, including long-acting injectable, oral, and implantable products. Phase 3 data support the efficacy of nanoformulated injectable cabotegravir and rilpivirine for HIV treatment in patients with undetectable viremia, but we have yet to learn how this strategy may benefit those with medication adherence challenges. Despite this, the affected community and HIV providers are very interested in exploring the role of long-acting therapies to address some types of barriers to medication adherence. This review summarizes available information about the potential for long-acting therapy to improve adherence for some patients and outlines associated opportunities and challenges with the implementation of long-acting therapy for the treatment and prevention of HIV.

Download Full-text

SimpactCyan 1.0: An Open-source Simulator for Individual-Based Models in HIV Epidemiology with R and Python Interfaces

10.1101/440834 ◽

2018 ◽

Cited By ~ 1

Author(s):

Jori Liesenborgs ◽

Diana M Hendrickx ◽

Elise Kuylen ◽

David Niyukuri ◽

Niel Hens ◽

...

Keyword(s):

Open Source ◽

Hiv Infections ◽

Hiv Treatment ◽

Model Parameters ◽

Eligibility Criteria ◽

Hiv Epidemiology ◽

Treatment And Prevention ◽

Individual Based Models ◽

Prevention Programmes ◽

The Impact

ABSTRACTSimpactCyan is an open-source simulator for individual-based models in HIV epidemiology. Its core algorithm is written in C++ for computational efficiency, while the R and Python interfaces aim to make the tool accessible to the fast-growing community of R and Python users. Transmission, treatment and prevention of HIV infections in dynamic sexual networks are simulated by discrete events. A generic “intervention” event allows model parameters to be changed over time, and can be used to model medical and behavioural HIV prevention programmes. First, we describe a more efficient variant of the modified Next Reaction Method that drives our continuous-time simulator. Next, we outline key built-in features and assumptions of individual-based models formulated in SimpactCyan, and provide code snippets for how to formulate, execute and analyse models in SimpactCyan through its R and Python interfaces. Lastly, we give two examples of applications in HIV epidemiology: the first demonstrates how the software can be used to estimate the impact of progressive changes to the eligibility criteria for HIV treatment on HIV incidence. The second example illustrates the use of SimpactCyan as a data-generating tool for assessing the performance of a phylodynamic inference framework.

Download Full-text

SWTICH DE ESQUEMAS ANTIRRETROVIRAIS DURANTE A PANDEMIA DE COVID-19 EM UM CENTRO DE REFERÊNCIA DA AMÉRICA LATINA

RAHIS ◽

10.21450/rahis.v18i4.7306 ◽

2021 ◽

Vol 18 (4) ◽

pp. 168-169

Author(s):

Dirce Inês Silva ◽

Isabela Estrela Santos ◽

Jaqueline Xavier Oliveira

Keyword(s):

Research Society ◽

Hiv Treatment ◽

Services Research ◽

Prevention Services ◽

Treatment And Prevention ◽

The Social ◽

America Latina ◽

Terapia Antirretroviral ◽

The Impact ◽

Brazilian Journal

INTRODUÇÃO : O tratamento da infecção pelo vírus da imunodeficiência humana (HIV) é realizado por meio da terapia antirretroviral (TARV) e vem apresentando avanços importantes no decorrer dos anos. Ocorreu a introdução de novas drogas e classes que ampliaram de modo significativo as opções para o tratamento da infecção pelo HIV-1. Existem razões para a troca (Swtich) da TARV, são eles : manutenção da supressão viral, resistência, probabilidade de maior adesão ao tratamento, eventos adversos, interações medicamentosas (1). Durante a pandemia de Covid-19 que vivenciamos desde março de 2020 no Brasil muitas dificuldades ocorreram nos serviços de saúde, principalmente para as pessoas que vivem com HIV como : acesso aos serviços, diagnóstico, tratamento e acompanhamento (2.3). OBJETIVO: Avaliar a prevalência de trocas de esquemas em um centro de referência da América Latina no período de Janeiro de 2020 a 31 de Julho de 2021.METODOLOGIA : Realizamos um estudo transversal no período de 2020 a 2021 , utilizando o sistema de informação : Sistema de Controle Logístico de Medicamentos (SICLOM) do Ministério da Saúde . Os dados foram analisados no Statistical Package for the Social Science(SPSS® ) 22.RESULTADOS : No período do estudo foram detectadas 473 trocas. Em 2020 ocorreram 283 trocas, 83 em mulheres e 200 em homens. E 2021 até o dia 31/07/2021 foram detectadas 190 trocas, 76 ocorreram em mulheres e 114 em homens. As trocas ocorreram devido : resistência, reações adversas, gestação , tratamento concomitante da tuberculose e simplificação do tratamento ( Figura 1 e 2)). Figura 1 – Ocorências de Swtich de esquemas antirretroviraisFigura 2- Razões de Trocas de Esquemas Antiretrovirais CONCLUSÃO : Swtich dos esquemas antirretrovirais em utilização pode ser uma estratégia de simplificação da TARV, melhoria da adesão, e em muitos casos a redução de eventos adversos. O arsenal terapêutico no contexto brasileiro é diversificado permitindo uma troca com segurança e sem risco de perda da eficácia virológica. Sendo uma estratégia para enfrentamento da infecção pelo HIV mesmo em tempos de pandemia do COVID19. REFERÊNCIAS:1-Brites, Carlos. Terapia antirretroviral atual: tendências e desafios. Estratégias de troca (switch) naterapia antirretroviral atual. Brazilian Journal of Infectious DiseaseVol 2 . Nº 1 . Fevereiro 20162- Moura, Maria Lucia Costa de. (2020). Coronavírus e COVID-19. Revista Saúde Coletiva, 53, 10.3- Parente, J. da S.; Azevedo, S. L. de .; Moreira, L. da F. A.; Abreu, L. M. .; Souza, L. V. de. The impact of social isolation on the COVID-19 pandemic on access to HIV treatment and prevention services. Research, Society and Development, [S. l.], v. 10, n. 1, p. e28110111692, 2021.

Download Full-text

Revised guidelines for HIV testing, counselling, and screening in the United States

Weekly releases (1997–2007) ◽

10.2807/esw.06.01.01998-en ◽

2002 ◽

Vol 6 (1) ◽

Author(s):

K. A. Fenton ◽

C McGarrigle

Keyword(s):

United States ◽

Pregnant Women ◽

Service Providers ◽

The United States ◽

Hiv Treatment ◽

Hiv Screening ◽

Policy Makers ◽

Treatment And Prevention ◽

Perinatally Acquired ◽

Clinical Advances

The Centers for Disease Control (CDC) in the United States has published a report containing revised guidelines for HIV counselling, testing, and referral (CTR), and revised recommendations for HIV screening of pregnant women (1). The CTR guidelines replace the existing 1994 guidelines (2) and contain recommendations for policy-makers and service providers of HIV CTR. The revised recommendations for HIV screening for pregnant women replace the 1995 guidelines (3). The revision was prompted by recent advances in both HIV CTR and HIV treatment and prevention and clinical advances in preventing perinatally acquired HIV.

Download Full-text

Shadow of HIV exceptionalism 40 years later

Journal of Medical Ethics ◽

10.1136/medethics-2020-106908 ◽

2021 ◽

pp. medethics-2020-106908

Author(s):

Michela Blain ◽

Stephaun E Wallace ◽

Courtney Tuegel

Keyword(s):

Implicit Bias ◽

Hiv Treatment ◽

Hiv Care ◽

Medical Community ◽

Aids Epidemic ◽

Treatment And Prevention ◽

The Social ◽

Hiv Exceptionalism ◽

Medical Advances

During the AIDS epidemic in the 1980s, it was crucial that providers take steps to protect patients by managing HIV with the perspective of ‘HIV exceptionalism’. However, in 2020, the social and historical barriers erected by this concept, as demonstrated in this patient’s case, are considerably impeding progress to end the epidemic. With significant medical advances in HIV treatment and prevention, the policies informed by HIV exceptionalism now paradoxically perpetuate stigma and inequities, particularly for people of colour. To improve overall HIV care, the medical community must move past HIV exceptionalism by liberalising diagnostics, instituting clinician implicit bias training and advocating to fully decriminalise HIV non-disclosure.

Download Full-text

Motivational Interviewing and Technology

Motivational Interviewing in HIV Care ◽

10.1093/med/9780190619954.003.0016 ◽

2019 ◽

pp. 149-154

Author(s):

Megan Mueller ◽

Heidi Hutton ◽

Larry Chang ◽

Lisa Hightow-Weidman ◽

Kelly Amy Knudtson ◽

...

Keyword(s):

Motivational Interviewing ◽

Mobile Phones ◽

Stages Of Change ◽

Computer Programs ◽

Hiv Treatment ◽

Mobile Platforms ◽

Behavioral Skills ◽

Face To Face ◽

Treatment And Prevention ◽

Use Of Technology

Motivational interviewing (MI) was developed as a face-to-face intervention. However, increasing use of technology for mobile and electronic health approaches have adapted MI to be delivered via several technology-enabled platforms. Chapter 15 offers several examples of using MI with mobile platforms. Although these examples draw from a situated information, motivation, behavioral skills model–based approach, the use of texts, mobile phones, and computer programs to help identify potential positions on stages of change are highly generalizable. These three intervention packages detail the development and implement of technology enabled, MI-informed interventions for HIV treatment and prevention.

Download Full-text