AIDS Research and Treatment最新文献

{"title":"Viral Load Suppression after Enhanced Adherence Counseling and Its Predictors among High Viral Load HIV Seropositive People in North Wollo Zone Public Hospitals, Northeast Ethiopia, 2019: Retrospective Cohort Study.","authors":"Gedefaw Diress, Samuel Dagne, Birhan Alemnew, Seteamlak Adane, Amanuel Addisu","doi":"10.1155/2020/8909232","DOIUrl":"10.1155/2020/8909232","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization currently encourages enhanced adherence counseling for human immunodeficiency virus (HIV) seropositive people with a high viral load count before a treatment switch to the second-line regimen, yet little is known about viral load suppression after the outcome of enhanced adherence counseling. Therefore, this study aimed to assess viral suppression after enhanced adherence counseling sessions and its predictors among high viral load HIV seropositive people.</p><p><strong>Methods: </strong>Institutional-based retrospective cohort study was conducted among 235 randomly selected HIV seropositive people who were on ART and had a high viral load (>1000 copies/ml) from June 2016 to January 2019. The proportion of viral load suppression after enhanced adherence counseling was determined. Time to completion of counseling sessions and time to second viral load tests were estimated by the Kaplan-Meier curve. Log binomial regression was used to identify predictors of viral re-suppression after enhanced adherence counseling sessions.</p><p><strong>Result: </strong>The overall viral load suppression after enhanced adherence counseling was 66.4% (60.0-72.4). The median time to start adherence counseling session after high viral load detected date was 8 weeks (IQR 4-8 weeks), and the median time to complete the counseling session was 13 weeks (IQR 8-25 weeks). The probability of viral load suppression was higher among females (ARR = 1.2, 95% CI: 1.02-1.19) and higher educational status (ARR = 1.7, 95% CI: 1.25-2.16). The probability of viral load suppression was lower among people who had 36-59 months duration on ART (ARR = 0.35, 95% CI: 0.130-0.9491) and people who had > 10,000 baseline viral load count (ARR = 0.44, 95% CI: 0.28-0.71).</p><p><strong>Conclusion: </strong>This study showed that viral suppression after enhanced adherence counseling was near to the WHO target (70%) but highlights gaps in time to enrolment into counseling session, timely completion of counseling session, and repeat viral load testing after completing the session.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8909232"},"PeriodicalIF":1.7,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37905272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Adaptive Optimal Set Points of CD4⁺ Count Clinical Covariates at Each Phase of the HIV Disease Progression.","authors":"Partson Tinarwo, Temesgen Zewotir, Delia North","doi":"10.1155/2020/1379676","DOIUrl":"10.1155/2020/1379676","url":null,"abstract":"<p><p>In response to invasion by the human immunodeficiency virus (HIV), the self-regulatory immune system attempts to restore the CD4⁺ count fluctuations. Consequently, many clinical covariates are bound to adapt too, but little is known about their corresponding new optimal set points. It has been reported that there exist few strongest clinical covariates of the CD4⁺ count. The objective of this study is to harness them for a streamlined application of multidimensional viewing lens (statistical models) to zoom into the behavioural patterns of the adaptive optimal set points. We further postulated that the optimal set points of some of the strongest covariates are possibly controlled by dietary conditions or otherwise to enhance the CD4⁺ count. This study investigated post-HIV infection (acute to therapy phases) records of 237 patients involving repeated measurements of 17 CD4⁺ count clinical covariates that were found to be the strongest. The overall trends showed either downwards, upwards, or irregular behaviour. Phase-specific trends were mostly different and unimaginable, with LDH and red blood cells producing the most complex CD4⁺ count behaviour. The approximate optimal set points for dietary-related covariates were total protein 60-100 g/L (acute phase), <85 g/L (early phase), <75 g/L (established phase), and >85 g/L (ART phase), whilst albumin approx. 30-50 g/L (acute), >45 g/L (early and established), and <37 g/L (ART). Sodium was desirable at approx. <45 mEq/L (acute and early), <132 mEq/L (established), and >134 mEq/L (ART). Overall, desirable approximates were albumin >42 g/L, total protein <75 g/L, and sodium <137 mEq/L. We conclude that the optimal set points of the strongest CD4⁺ count clinical covariates tended to drift and adapt to either new ranges or overlapped with the known reference ranges to positively influence the CD4⁺ cell counts. Recommendation for phase-specific CD4⁺ cell count influence in adaptation to HIV invasion includes monitoring of the strongest covariates related to dietary conditions (sodium, albumin, and total protein), tissue oxygenation (red blood cells and its haematocrit), and hormonal control (LDH and ALP).</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"1379676"},"PeriodicalIF":1.7,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1379676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37752348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral Suppression and Its Associated Factors in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Study in the Ho Municipality, Ghana","authors":"S. Lokpo, Patrick Jnr Ofori-Attah, L. Ameke, C. Obirikorang, V. Orish, G. E. Kpene, E. Agboli, Gideon Kye-Duodu, J. Deku, Benedict Awadzi, Mark Noagbe, Seyram Tetteh Quarshie","doi":"10.1155/2020/9247451","DOIUrl":"https://doi.org/10.1155/2020/9247451","url":null,"abstract":"Background. The WHO targets to end HIV/AIDS as a public health problem by 2030. The introduction of the ambitious “90-90-90” strategy to attain this target is expected to be achieved by the year 2020. However, there is lack of regional data, especially on the third “90.” This study sought to assess the rate and associated factors of viral suppression among people living with HIV (PLWH) on highly active antiretroviral therapy (HAART) at the Antiretroviral Therapy (ART) Clinic in a Ghanaian health facility. Method. The study design was a retrospective analysis of secondary data of 284 HIV registrants on HAART for at least 6 months at the ART Clinic from July 2016 to April 2019. Data on sociodemography including age, gender, marital status, education, and occupation as well as pharmacological (type of medication and duration on medication) and laboratory variable (current viral load results) were extracted from patients’ folders. Viral suppression and failure were determined using the WHO definitions (viral suppression as viral load ). However, regular clinic attendance (used as proxy for medication adherence) ( ) and being on HAART for more than three (3) years ( ) were associated with viral suppression. Conclusion. The rate of viral suppression among PLWH on HAART in the Ho municipality fell short of the WHO target. However, the study identified regular ART clinic attendance and treatment >3 years as factors associated with viral suppression.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 1","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2020-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9247451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41629807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing Positive and Disclosing in Pregnancy: A Phenomenological Study of the Experiences of Adolescents and Young Women in Maseru, Lesotho.","authors":"Sphiwe Madiba,&nbsp;Mamorapeli Putsoane","doi":"10.1155/2020/6126210","DOIUrl":"https://doi.org/10.1155/2020/6126210","url":null,"abstract":"<p><p>The routine antenatal screening through the prevention of mother to child transmission of HIV (PMTCT) services results in pregnancy being often the point at which an HIV diagnosis is made. Disclosure to partners presents particular complexities during pregnancy. However, research on the pattern and experiences of disclosure in pregnancy is limited in Lesotho, despite the high prevalence of HIV among pregnant women. The aim of this study was to explore and describe the disclosure experiences of adolescent girls and young women (AGYW) after receiving a positive HIV test result during pregnancy. <i>Methods</i>. Descriptive phenomenology using semistructured in-depth interview was used to collect data from AGYM sampled purposively from PMTCT sites located in urban areas of Maseru, Lesotho. Data analysis was inductive and followed the thematic approach. <i>Findings</i>. There were 15 AGYW involved in this study with the mean age of 20 years. Fourteen reported being pregnant with their first child and perceived HIV testing in antenatal care as compulsory. Ten AGYM disclosed their HIV status in the immediate posttesting period to protect their partners from HIV infection. The narratives revealed that the AGYM hoped that after disclosing, the partner would be tested for HIV. Furthermore, the AGYM disclosed because they wanted freedom to take their medication. Their experience of disclosure was relief, as they did not have to hide their HIV status. The AGYM reported being supported to adhere to medication and clinic attendance by their partners who also provided emotional support to them to deal with being HIV positive and pregnant. <i>Conclusion</i>. The AGYM recounted an overall positive experience of disclosure to their partners who agreed to test for HIV and adopted safe sex practices. This has positive implications for the PMTCT programme and the involvement of men in reproductive health. Therefore, there is need to integrate disclosure and partner testing interventions in the cascade of services in PMTCT programmes.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"6126210"},"PeriodicalIF":1.7,"publicationDate":"2020-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6126210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37678377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Men in Moshi District of Tanzania.","authors":"Yuwei Cheng, Elijah Paintsil, Musie Ghebremichael","doi":"10.1155/2020/7607834","DOIUrl":"10.1155/2020/7607834","url":null,"abstract":"<p><p>The syndromic diagnosis of sexually transmitted infections (STIs) is widely recognized as the most practical, feasible, and cost-effective diagnostic tool in resource-limited settings. This study assessed the diagnostic accuracy of syndromic versus laboratory testing of STIs among 794 men randomly selected from the Moshi district of Tanzania. Participants were interviewed with a questionnaire that included questions on history of STIs symptoms. Blood and urine samples were taken from the participants for laboratory testing. Only 7.9% of the men reported any symptoms of STI; however, 46% of them tested positive for at least one STI. There was little agreement between syndromic and laboratory-confirmed diagnoses, with low sensitivity (0.4%-7.4%) and high specificity (96%-100%) observed for each individual symptom. The area under the receiver-operating curve was 0.528 (95% CI: 0.505-0.550), indicating that the syndromic approach has a 52.8% probability of correctly identifying STIs in study participants. In conclusion, whenever possible, laboratory diagnosis of STI should be favored over syndromic diagnosis.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"7607834"},"PeriodicalIF":1.1,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37670572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic and Behavioral Factors Associated with HIV Vulnerability according to Sexual Orientation.","authors":"Maria Aparecida A O Serra,&nbsp;Antoninho B Milhomem,&nbsp;Samae B Oliveira,&nbsp;Francisca Aline A S Santos,&nbsp;Roberta Araújo E Silva,&nbsp;Ana Cristina P J Costa,&nbsp;Maria da Conceição S O Cunha,&nbsp;Antônio Uelton A Silva,&nbsp;Roberto Wagner J F Freitas,&nbsp;Márcio Flávio M Araújo","doi":"10.1155/2020/5619315","DOIUrl":"https://doi.org/10.1155/2020/5619315","url":null,"abstract":"<p><strong>Objective: </strong>To analyze sociodemographic and behavioral factors associated with vulnerability to HIV according to sexual orientation.</p><p><strong>Method: </strong>This is a cross-sectional study conducted using data on 3,818 people in the city of Imperatriz, Brazil, during 2015 and 2016. The survey's questionnaires addressed sociodemographic and behavioral variables. For the data analysis, association (chi-square test) and strength of association (odds ratio) were observed. A significance level of <i>p</i> < 0.05 and adjustment for age and gender were taken into consideration.</p><p><strong>Results: </strong>A substantial portion of the sample stated they were heterosexual (88.8%). These individuals demonstrated a lower chance of HIV infection (<i>p</i> < 0.001), sexually transmitted infections (<i>p</i> < 0.001), alcohol use (<i>p</i> < 0.001) and condom use (<i>p</i> < 0.001), compared to men who have sex with men and/or bisexuals. In this group, after adjusting for confounding variables, the factors associated with HIV infection were being male (<i>p</i> < 0.001), unmarried (<i>p</i> < 0.001), having completed higher education (<i>p</i> < 0.001) and boasting multiple sexual partners (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Behavioral and sociodemographic factors of vulnerability to HIV are predominant among men who have sex with men and/or are bisexual.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"5619315"},"PeriodicalIF":1.7,"publicationDate":"2020-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5619315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37939259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Isoniazid Preventive Therapy Provide Better Treatment Outcomes in HIV-Infected Individuals in Northern Ethiopia? A Retrospective Cohort Study.","authors":"Tesfay Mehari Atey,&nbsp;Helen Bitew,&nbsp;Solomon Weldegebreal Asgedom,&nbsp;Asrat Endrias,&nbsp;Derbew Fikadu Berhe","doi":"10.1155/2020/7025738","DOIUrl":"https://doi.org/10.1155/2020/7025738","url":null,"abstract":"<p><strong>Objectives: </strong>Early antiretroviral therapy (ART), isoniazid preventive therapy (IPT), and isoniazid-rifapentine (3HP) are effective strategies for preventing tuberculosis (TB) among people living with HIV (PLHIV). The study aimed to determine the effect of IPT on the TB incidence, follow-up CD4⁺ T cells, and all-cause mortality rate. <i>Participants</i>. Eligible patients on ART (<i>n</i> = 1, 863) were categorized into one-to-two ratios of exposed groups to IPT (<i>n</i> = 621) and nonexposed groups to IPT (<i>n</i> = 1, 242). Exposed groups entered the cohort at their first prescription of IPT, and unexposed groups entered into the study at the first prescription of ART and then followed until the occurrence of the outcome or date of administrative censoring (June 30, 2017). The outcome endpoints were TB incidence, follow-up CD4⁺ T cells, and all-cause mortality rate.</p><p><strong>Results: </strong>The follow-up CD4⁺ T cells for the exposed and nonexposed groups were 405.74 and 366.95 cells/mm (World Health Organization (WHO), 2017), respectively, a statistically significant finding (<i>t</i> ₁₈₆₁ = -3.770, <i>p</i> < 0.0001; Cohen's <i>d</i> = 0.186). Nine percent of the exposed patients (620 incidence of TB per 100,000 person-years (PYs)) and 21.9% of the nonexposed patients (3160 incidence of TB per 100,000 PYs) developed TB. Mortality rate (per 100,000 PYs) was 440 for the exposed and 1490 for the unexposed patients. Statistically significant determinants of the all-cause mortality were unscheduled follow-up (AHR = 1.601; 95% CI: 1.154-2.222) and unable to work properly (AHR = 2.324; 95% CI: 1.643-3.288).</p><p><strong>Conclusion: </strong>This study demonstrates the effect of IPT in reducing incidence of TB and all-cause mortality rate and improving follow-up CD4⁺ T cells. Promoting IPT use can help to achieve the TB eradicating national agenda in Ethiopia.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"7025738"},"PeriodicalIF":1.7,"publicationDate":"2020-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7025738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37939260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Gaborone, Botswana: Factors Associated with Change in Body Mass Index.","authors":"Jose Gaby Tshikuka,&nbsp;Mgaywa Gilbert Mjungu Damas Magafu,&nbsp;Goabaone Rankgoane-Pono,&nbsp;Julius Chacha Mwita,&nbsp;Tiny Masupe,&nbsp;Shimeles Genna Hamda,&nbsp;Roy Tapera,&nbsp;Mooketsi Molefi,&nbsp;Joseph Tshibangu,&nbsp;John Thato Tlhakanelo","doi":"10.1155/2020/8016791","DOIUrl":"https://doi.org/10.1155/2020/8016791","url":null,"abstract":"<p><strong>Background: </strong>Factors associated with overweight/obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana.</p><p><strong>Objectives: </strong>To: (i) estimate the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) assess changes in BMI categories among ART recipients between their first clinic visit (BMI-1) and their last clinic visit (BMI-2), (iii) identify ART regimen that predicts overweight/obesity better than the others and factors associated with BMI changes among ART recipients.</p><p><strong>Methods: </strong>A 12-year retrospective record-based review was conducted. Potential predictors of BMI change among patients after at least three years of ART exposure were examined using a multiple logistic regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients' demographic and biomedical characteristics including the presence or absence of diabetes mellitus-related comorbidities (DRC), defined as any morbidity associated with type 2 diabetes as described in the international statistical classification of diseases and related health problems (ICD-10-CM) codebook index, were investigated as potential predictors of overweight/obesity.</p><p><strong>Results: </strong>Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obese recipients were more likely to be female, to have DRC and less likely to have CD4 count between 201 and 249 cells/mm³. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity better than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART.</p><p><strong>Conclusion: </strong>These results suggest that the ART regimens studied have a comparable effect on overweight/obesity and that the duration of exposure does not affect the outcome. This study calls for further research to elucidate the relative contribution of various factors to BMI change among recipients, including ART regimens.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8016791"},"PeriodicalIF":1.7,"publicationDate":"2020-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8016791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37924010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Management of Patients with Detectable Viral Load after the Implementation of Routine Viral Load Monitoring in an Urban HIV Clinic in Uganda.","authors":"Nsumba Steven Mark,&nbsp;Musomba Rachel,&nbsp;Arvind Kaimal,&nbsp;Mubiru Frank,&nbsp;Tibakabikoba Harriet,&nbsp;Lwanga Isaac,&nbsp;Mohammed Lamorde,&nbsp;Castelnuovo Barbara","doi":"10.1155/2019/9271450","DOIUrl":"https://doi.org/10.1155/2019/9271450","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical decisions taken for patients failing on treatment and possible implementation leakages within the monitoring cascade at a large urban HIV Centre in Kampala, Uganda.</p><p><strong>Methods: </strong>As per internal clinic guidelines, VL results >1,000 copies/ml are flagged by a quality assurance officer and sent to the requesting clinician. The clinician fills a \"decision form\" choosing: (1) refer for adherence counselling, (2) repeat VL after 3 months, and (3) switch to second line. We performed data extraction on a random sample of 100 patients with VL test >1,000 copies/ml between January and August 2015. For each patient, we described the action taken by the clinicians.</p><p><strong>Results: </strong>Of 6,438 patients with VL performed, 1,021 (16%) had >1,000 copies/ml. Of the 100 (10.1%) clinical files sampled, 61% were female, median age was 39 years (IQR: 32-47), 81% were on 1^st-line ART, 19% on 2^nd-line, median CD4 count was 249 cells/<i>µ</i>L (IQR: 145-390), median log₁₀ VL 4.42 (IQR: 3.98-4.92). Doctors' decisions were; refer for adherence counseling 49%, repeat VL for 25%, and switch to second line for 24% patients. Forty-one percent were not managed according to the guidelines. Of these, 29 (70.7%) were still active in care, 7 were tracked [5 (12.2%) lost to program, 2 (4.9%) dead] and 5 patients were not tracked.</p><p><strong>Conclusion: </strong>Despite the implementation of internal systems to manage patients failing ART, we found substantial leakages in the monitoring \"cascade\". Additional measures and stronger clinical supervision are needed to make every test count, and to ensure appropriate management of patients failing on ART.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2019 ","pages":"9271450"},"PeriodicalIF":1.7,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9271450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37540615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child-Centred Care in HIV Service Provision for Children in Resource Constrained Settings: A Narrative Review of Literature.","authors":"Chipo Mutambo,&nbsp;Kemist Shumba,&nbsp;Khumbulani W Hlongwana","doi":"10.1155/2019/5139486","DOIUrl":"10.1155/2019/5139486","url":null,"abstract":"<p><strong>Introduction: </strong>Child-centred care approaches are increasingly gaining traction in healthcare; and are being applied in the delivery of HIV care for children in resource constrained settings. However, very little is known about their potential benefits.</p><p><strong>Methods: </strong>We synthesised literature from primary and secondary publications exploring the philosophical underpinnings of the concept of child-centred care, and its application to HIV service delivery for children in resource constrained settings. We concluded the review by suggesting a conceptual framework for mainstreaming and integrating child-centred care approaches in the management of HIV in resource constrained settings.</p><p><strong>Results: </strong>The philosophical underpinnings of child-centred care stem from human rights (child-rights), holism, the ecological model, and life-cycle approaches. Although there is no standard definition of child-centred care in the context of HIV, the literature review highlighted several phrases used to describe the \"child-centredness\" of HIV care for children. These phrases include: (i) Respect for child-healthcare rights. (ii) Using the lifecycle approach to accommodate children of different ages. (iii) Provision of age-appropriate HIV services. (iv) Meaningful participation and inclusion of the child in the healthcare consultation process. (v) Using age-appropriate language to increase the child's understanding during healthcare consultations. (vi) Age-appropriate disclosure. (vii) Primary caregiver (PCG) participation and preparation (equipping the PCGs with information on how to support their children). (viii) Creation of a child-friendly healthcare environment. (ix) Consideration of the child ecological systems to have a holistic understanding of the child. (x) Partnership and collaborative approach between children, PCGs, and healthcare workers (HCWs).</p><p><strong>Conclusion: </strong>Child-centred care approaches can potentially increase child-participation, promote positive health outcomes and resilience in children living with a communicable, highly stigmatised and chronic condition such as HIV. More evidence from controlled studies is required to provide concrete results to support the application of child-centred care approaches in HIV care services.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2019 ","pages":"5139486"},"PeriodicalIF":1.7,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5139486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}