Impact of HIV infection on COVID-19 clinical outcome In June 2020, STI shared a podcast describing the first available data about the outcomes of COVID-19 related hospitalisation for people living with HIV (PLWH). We shared some take-home points: 1) Encourage disclosure of known HIV status on COVID-19 related hospital admittance 2) Encourage HIV testing […]
Category: HIV treatment cascade
HIV epidemic in Indonesia: Are we there yet?
In this the second STI podcast of 2021, we focus on the HIV epidemic in Indonesia and how the country strives to meet the UNAIDS 90-90-90 UNAIDS sustainability goals for people living with HIV (PLWH). Episode Highlights: Indonesia is a densely populated country spread over 17,000 islands of stunning beauty. It has one of the […]
Anti-HIV strategies in limited resource settings set the pattern for combating other diseases
HIV-specific interventions in poor regions of the world like sub-Saharan Africa may have benefits for their health systems that exceed the initial aims of those interventions (How should HIV-specific charitable interventions like PEPFAR be evaluated? (STI/blog)). This is the encouraging message coming out of a recent evaluation of treatment of rheumatoid heart disease (RHD) in […]
What is the potential of ‘Treatment for Prevention’ in fighting HIV/AIDS?
UNAIDS 90:90:90 appears to have set the course for a global ‘treatment as prevention’ strategy. In 2015 the US revised its National HIV/AIDS Strategy (NHAS) to harmonize its goals with UNAIDS 90% targets for testing, engagement in care, and virological suppression. Though the HIV/AIDS community have been nervous about the impact of the recent change […]
Achieving UNAIDS 90-90-90: More haste less speed?
UNAIDS (2014) has set targets for HIV management that seem ambitious, if not unrealistically so (UNAIDS: 90-90-90): 90% of those living with HIV to know their status; 90% of known HIV+ individuals to undergo ART initiation; 90% of ART+ initiated to achieve viral suppression. A one-year-in report from a large cluster-randomized study of home-based testing […]
HPTN 071 attempts universal home-based HIV testing in sub-Saharan Africa: scaling the mountainous challenge of UNAIDS 90-90-90 target
Estimates of 96% for the preventative efficacy of ART against HIV transmission, reported in 2011 by Myron & Cohen (M&C), appeared at last to place long-term containment of the epidemic in our hands. In the wake of this, UNAIDS: 90-90-90 proposed ambitious targets: 90% of those living with HIV to know their status; 90% of […]
The PrEP ‘care continuum/cascade’: how would it look?
We take for granted the value of the care continuum (or ‘cascade’), now increasingly seen as the key measure of health system response to HIV (Cassell (STIs editorial)). The application of this model to HIV has provided a benchmark for evaluation in contexts as diverse as Moscow (Wirtz & Beyrer (STIs)), South Africa (Schwartz & […]
A case for immediate ART initiation in all HIV diagnosed, regardless of CD4+ count?
The year 2013 saw the WHO recommended threshold for treatment of HIV+ patients with ART rise from a count of 350 CD4+ per mm3 to one of 500 CD4+ per mm3.. The threshold had been fixed as early as three years before (2010) at 350 CD4+ per mm3 (WHO ART recommendations). These recommendations have doubtless […]
Retention in care rather than diagnosis may prove the ultimate challenge for US HIV response
The real challenge which the US HIV/AIDS epidemic poses for the US public health services is not simply to achieve higher levels of diagnosis – but, far more than that, to improve linkage to, and retention in, care. This claim is hardly controversial. But it is thrown into stark relief in a recent study by […]