HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes
Wim Delva,Jeffrey W. Eaton,Fei Meng,Christophe Fraser,Richard G. White,Peter Vickerman,Marie-Claude Boily,Timothy B. Hallett +7 more
TLDR
In re-evaluating the allocation of ART in light of the new data about ART preventing transmission, the goal should be to create policies that maximise epidemiological and clinical benefit while still being feasible, affordable, acceptable, and equitable.Abstract:
Until now, decisions about how to allocate ART have largely been based on maximising the therapeutic benefit of ART for patients. Since the results of the HPTN 052 study showed efficacy of antiretroviral therapy (ART) in preventing HIV transmission, there has been increased interest in the benefits of ART not only as treatment, but also in prevention. Resources for expanding ART in the short term may be limited, so the question is how to generate the most prevention benefit from realistic potential increases in the availability of ART. Although not a formal systematic review, here we review different ways in which access to ART could be expanded by prioritising access to particular groups based on clinical or behavioural factors. For each group we consider (i) the clinical and epidemiological benefits, (ii) the potential feasibility, acceptability, and equity, and (iii) the affordability and cost-effectiveness of prioritising ART access for that group. In re-evaluating the allocation of ART in light of the new data about ART preventing transmission, the goal should be to create policies that maximise epidemiological and clinical benefit while still being feasible, affordable, acceptable, and equitable.read more
Citations
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Scale-up of combination prevention and antiretroviral therapy for female sex workers in West Africa: time for action.
Michel Alary,Catherine M Lowndes,Philippe Van de Perre,Luc Béhanzin,Georges Batona,Fernand Guédou,Issouf Konate,Isidore Traore,Comfort Asamoah-Adu,Evelyne Akinocho,Nicolas Nagot +10 more
TL;DR: Analysis of HIV transmission dynamics indicates largely concentrated HIV epidemics in these 10 countries, with over 75% of prevalent cases of HIV among men were related to sexual intercourse with FSWs.
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A primer on multiscale modelling of infectious disease systems.
TL;DR: The foundational concepts presented in this primer will be central in articulating an integrated and more refined disease control theory based on multiscale modelling - the all-encompassing quantitative representation of an infectious disease system.
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Reduced darunavir dose is as effective in maintaining HIV suppression as the standard dose in virologically suppressed HIV-infected patients: a randomized clinical trial
José Moltó,Marta Valle,Elena Ferrer,Pere Domingo,Adrian Curran,José R. Santos,Maria Gracia Mateo,María Silvana Di Yacovo,Cristina Miranda,Daniel Podzamczer,Bonaventura Clotet,Josep Coll,Silvia Gel,Josep M. Llibre,Beatriz Mothe,Eugenia Negredo,Núria Pérez-Álvarez,Guillem Sirera,María Silvana DiYacovo,Nerea Rozas,Antonia Vila,Maria del Mar Gutierrez,Gracia Mateo,Joaquin Burgos,Jordi Navarro,Esteban Ribera +25 more
TL;DR: The efficacy of a darunavir daily dose of 600 mg seemed to be similar to the efficacy of the standard 800 mg dose in virologically suppressed HIV-infected patients on triple ART.
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A Prospective Study of Intimate Partner Violence as a Risk Factor for Detectable Plasma Viral Load in HIV-Positive Women Engaged in Transactional Sex in Mombasa, Kenya
Kate Wilson,George Wanje,Krista Yuhas,Jane M. Simoni,Linnet Masese,Ann Vander Stoep,Walter Jaoko,James P. Hughes,Barbra A. Richardson,R. Scott McClelland +9 more
TL;DR: Qualitative findings revealed that women valued emotional and financial support from index partners, despite IPV, and IPV was not a major barrier to ART adherence, warranting further research.
Journal ArticleDOI
Exploring the population-level impact of antiretroviral treatment: the influence of baseline intervention context.
Sharmistha Mishra,Elisa Mountain,Michael Pickles,Peter Vickerman,Suresh Shastri,Charles F. Gilks,Nandini K. Dhingra,Reynold Washington,Marissa Becker,James F. Blanchard,Michel Alary,Marie-Claude Boily +11 more
TL;DR: In south India, maximizing FSWs’ access to care, followed by maximizing clients' access are the most efficient ways to expand antiretroviral treatment for HIV prevention, across baseline intervention context.
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