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 testing
COVID-19 and HIV: Calling attention to the importance of ensuring HIV status and testing is included in the management of COVID-19
As health care services worldwide undergo major reconfiguration to respond to the coronavirus crisis, there are simple and affordable ways to improve outcomes that relate to both HIV and COVID-19 care. The first step is to make sure that the HIV status is recorded on all hospital admissions relating to COVID-19. This in turn will […]
The risk network approach to HIV detection: something like contact tracing?
There has been considerable debate on the most effective and cost-effective means of accessing untested HIV- or STI-infected individuals. One frequently canvassed strategy is that of respondent driven sampling (RDS). This involves issuing suitable ‘seeds’ (e.g. recently diagnosed MSM) with coupons to distribute to others in their sexual or social networks. Wei & Raymond (STI) […]
Overcoming the obstacles to routine HIV testing in hospital settings
In both the UK (2008) and the US (2006) routine opt-out HIV screening is recommended in areas where the prevalence of HIV exceeds a certain threshold. Hospital emergency departments (ED) and acute medical units (ACU) are obvious settings where testing can be offered. Elgalib & Sabapathy (E&S), in a systematic review focussing on 14 studies […]
Modelling the scale-down of HIV services in sub-Saharan Africa
Search BMJ STI archive, and you will find frequent references to ‘scaling up’, and few – if any – to ‘scaling back’ or ‘scaling down’ (other than Parker/STI). Who knows if all this may not be about to change, if the US government goes ahead with threats to cut current foreign aid budget ear-marked for […]
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 & […]
Revised UK NICE Guidelines for HIV testing: why local prevalence based targeting by GPs and hospitals makes sense
November 2016 saw the publication of revised UK NICE Guidelines for HIV testing (last updated 2011) – only a few weeks before the appearance of the annual Public Health England Report: HIV in the UK/2016. The latter highlights the estimated level of still undiagnosed HIV in the UK (which, at 13,500/101,000, places us 3% short […]
UNAIDS 2016 Report: How a ‘life-cycle’ approach can help the world ‘get on the fast track’ to HIV prevention
‘Get on the Fast Track: a Life-cycle Approach to HIV’ is the latest UNAIDS report, following on from the UN Assembly’s 2016 declaration of commitment to ‘Fast Track’ goals for ending the HIV/AIDS epidemic. The major theme of the ‘life-cycle’ appears to owe much to the findings of the South African CAPRISA study – above […]