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Journal of the International AIDS Society, vol. 21 Issue no. 6 e 25142
Weaknesses in care programmes providing anti‐retroviral therapy (ART) persist and are often instigated by late ... HIV diagnosis and poor linkage to care. We investigated the potential for a home‐based counselling and testing (HBCT) campaign to be improved through the optimal timing and enhancement of testing rounds to generate greater health outcomes at minimum cost.
Countries implementing HBCT can reduce costs by optimally timing rounds and generate greater health outcomes through improving linkage, coverage, and retention. Tailoring HBCT campaigns to individual settings can enhance patient outcomes for minimal cost.
https://doi.org/10.1002/jia2.25142 more
Weaknesses in care programmes providing anti‐retroviral therapy (ART) persist and are often instigated by late ... HIV diagnosis and poor linkage to care. We investigated the potential for a home‐based counselling and testing (HBCT) campaign to be improved through the optimal timing and enhancement of testing rounds to generate greater health outcomes at minimum cost.
Countries implementing HBCT can reduce costs by optimally timing rounds and generate greater health outcomes through improving linkage, coverage, and retention. Tailoring HBCT campaigns to individual settings can enhance patient outcomes for minimal cost.
https://doi.org/10.1002/jia2.25142 more
PLoS ONE 9(6): e99880. doi:10.1371/journal.pone.0099880
Published June 17, 2014
Late presentation of HIV infection in the country of Georgia: 2012-2015
N. Chkhartishvili; O. Chokoshvili; N. Bolokadze, et al.
PLOS ONE; Georgios Nikolopoulos, University of Cyprus
(2017)
CC
PLOS ONE | https://doi.org/10.1371/journal.pone.0186835 October 30, 2017
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements
...
in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
more
Tokar A, et al. Sex Transm Infect 2019;95:193–200. doi:10.1136/sextrans-2018-053684
HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy
...
of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing services, HIV programmes and public health.
With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment.
This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
more
Management of mental health disorders in HIV-positive patients
G. Jonsson; N. Davies; C. Freeman; et al.
Southern African HIV Clinicians Society; AOSIS Publishing
(2013)
C2
Guideline
SAJHIVMED DECEMBER 2013, Vol. 14, No. 4
25 February 2021
This technical guidance is a living document that builds on guidelines and reports of the UNAIDS Joint Programme. The definitions contained herein are working definitions that are subject to change. Updates will also be added furth
...
er to the work of the multistakeholder Task Team on community-led AIDS responses that was recently established by the UNAIDS Executive Director and the UNAIDS Joint Programme, and which will conclude its task in December 2021.
more
Community consultation on the role of peer support in the Retention of women, adolescents and children in HIV care and treatment
World Health Organization ( WHO Regional Office for Africa), ICW, Unicef,
(2017)
C_WHO
16-17 November 2017,
Hotel Djeugua, Yaoundé, Cameroon
Meeting Report December 2017
Accessed June 17,2019
JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, Vol. 28, No. 2, March/April 2017, 186-198
http://dx.doi.org/10.1016/j.jana.2015.09.003
Technical Report
AIDS Medicines and diagnostics service
July 2015
Findings from field research in Malawi and current literature.
Policy brief. HIV testing services (HTS) and anti-retroviral therapy (ART) have been scaled up substantially. It is estimated that, globally, nearly 80% o
...
f people with HIV now know their status. With the offer of immediate ART initiation and improved treatment options, access to and uptake of treatment have increased, too. Now, most people with HIV who know their status are obtaining treatment and care.
In response to these changes in the global HIV epidemic, WHO is encouraging countries to use three consecutive reactive tests for an HIV-positive diagnosis as their treatment-adjusted prevalence and national HTS positivity fall below 5% .
more
Setting Global Research Priorities in Pediatric and Adolescent HIV Using the Child Health and Nutrition Research Initiative (CHNRI) Methodology
C. Irvine; A. Armstrong; J. M. Nagata; et al.
JAIDS Journal of Acquired Immune Deficiency Syndromes; Ovid
(2018)
C2
Supplement Article
J Acquir Immune Defic Syndr Volume 78, Supplement 1, August 15, 2018 www.jaids.com
WHO recommends replacing western blotting and line immunoassays with simpler tests in HIV testing services. These simpler tests include rapid diagn
...
ostic tests (RDTs) that can be used at the point-of-care, and enzyme immunoassays (EIAs).
These tests get results to the client faster, produce accurate results more often, cost less, can be performed by various cadres of health providers, and can thus facilitate greater access and uptake of HIV testing services among those who need it most.
more
Technical Guidance Note for Global Fund HIV Proposals - Reduction of HIV stigma and discrimination
World Health Organization; UNAIDS; Unicef
(2010)
C_WHO
Rationale for including this intervention in the proposal
Policy brief.
Globally, one in five people with HIV are unaware of their status, despite considerable scale up
...
of HIV testing, treatment and prevention services. Many of those unreached by HIV testing services (HTS) are from key populations, partners of people with HIV and, in Eastern and southern Africa, men and young people. Improving the availability, accessibility, friendliness and quality of services is important to address these testing gaps.
At the same time, tools and interventions that increase the demand for HTS are needed to reach people who are uninformed about HTS options and advances in treatment and prevention, people who are not motivated to seek HTS and those who are hesitant to test because of fear of an HIV diagnosis or other reasons.
more
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