The Spectrum of Engagement in HIV Care and its Relevance to Test-and-Treat Strategies for Prevention of HIV Infection
Edward M. Gardner,Margaret P. McLees,John F. Steiner,John F. Steiner,Carlos del Rio,William J. Burman +5 more
TLDR
The spectrum of engagement in care for HIV-infected individuals in the United States is reviewed and this information is applied to help understand the magnitude of the challenges that pooragement in care will pose to test-and-treat strategies for HIV prevention.Abstract:
For individuals with human immunodeficiency virus (HIV) infection to fully benefit from potent combination antiretroviral therapy, they need to know that they are HIV infected, be engaged in regular HIV care, and receive and adhere to effective antiretroviral therapy. Test-and-treat strategies for HIV prevention posit that expanded testing and earlier treatment of HIV infection could markedly decrease ongoing HIV transmission, stemming the HIV epidemic. However, poor engagement in care for HIV-infected individuals will substantially limit the effectiveness of test-and-treat strategies. We review the spectrum of engagement in care for HIVinfected individuals in the United States and apply this information to help understand the magnitude of the challenges that poor engagement in care will pose to test-and-treat strategies for HIV prevention.read more
Citations
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The end of AIDS: HIV infection as a chronic disease
TL;DR: Concerns are growing that the multimorbidity associated with HIV disease could affect healthy ageing and overwhelm some health-care systems, particularly those in resource-limited regions that have yet to develop a chronic care model fully.
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Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis
Ingrid T. Katz,Ingrid T. Katz,Annemarie E Ryu,A. Onuegbu,Christina Psaros,Sheri D. Weiser,David R. Bangsberg,Alexander C. Tsai +7 more
TL;DR: This review undertook a systematic assessment of the relationship between HIV‐related stigma and ART adherence to systematically assess the relationship with ART adherence itself.
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HIV infection: epidemiology, pathogenesis, treatment, and prevention
TL;DR: The role of immune activation in the pathogenesis of non-AIDS clinical events (major causes of morbidity and mortality in people on antiretroviral therapy) is receiving increased recognition and breakthroughs in the prevention of HIV important to public health include male medical circumcision.
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Human Immunodeficiency Virus Transmission at Each Step of the Care Continuum in the United States
Jacek Skarbinski,Eli S. Rosenberg,Gabriela Paz-Bailey,H. Irene Hall,Charles E. Rose,Abigail H. Viall,Jennifer L. Fagan,Amy Lansky,Jonathan Mermin +8 more
TL;DR: In this paper, a multistep, static, deterministic model was used to estimate the rate and number of HIV transmissions attributable to persons at each of the following 5 HIV care continuum steps: HIV infected but undiagnosed, HIV diagnosed but not retained in medical care, retained in care but not prescribed antiretroviral therapy, prescribed antirrhoehrgical therapy but not virally suppressed, and virally suppressing.
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The State of Engagement in HIV Care in the United States: From Cascade to Continuum to Control
TL;DR: This review synthesizes the state of engagement in HIV care in the United States, focusing on research, practice, and policy considerations, and includes a look to the future in addressing the greatest challenge and opportunity facing the authors' domestic HIV epidemic.
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