Dziva Chikwari et al. Implementation Science (2018) 13:70 https://doi.org/10.1186/s13012-018-0762-5
Policy Brief
Accessed: 20.11.2019
Médecins sans Frontières access campaign
Issue Brief
Accessed: 28.11.2019
These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV
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; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living with HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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Thirty-three years after its discovery, the Human Immunodeficiency Virus (HIV), responsible for the AIDS pandemic, remains a major public health problem despite advanced researches providing better diagnostic and therapeutic tools. The virus targets
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especially CD4+ T cells, leading to deficiency of the immune system and altering therefore defense against infections and cancer cells. Antiretroviral
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Policy Brief
Consolidated Guidelines
Updated 2016
WHO/HIV/2017.05
Overview
Rev Panam Salud Publica 40(6), 2016
Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV
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treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment needs of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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Version 3.0
Accessed: 24.11.2019