Antiretroviral Adherence and Development of Drug Resistance Are the Strongest Predictors of Genital HIV‐1 Shedding among Women Initiating Treatment

Graham, Susan M.; Masese, Linnet; Gitau, Ruth; Jalalian-Lechak, Zahra; Richardson, Barbra A.; Peshu, Norbert; Mandaliya, Kishor; Kiarie, James; Jaoko, Walter; Ndinya‐Achola, Jeckoniah; Overbaugh, Julie; McClelland, R. Scott

doi:10.1086/656790

Cited by 46 publications

(71 citation statements)

References 13 publications

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“…In two of three published studies, women on injectable contraceptives were more likely to have increased cervical RNA shedding. Two of these studies found no effect of DMPA on vaginal HIV shedding or plasma viremia [29][30][31]. Our results showing little or no effect of DMPA on acute plasma viremia or mucosal SHIV shedding suggest that the impact of DMPA on HIV shedding may be minimal.…”

Section: Discussionmentioning

confidence: 49%

Physiologic doses of depot-medroxyprogesterone acetate do not increase acute plasma simian HIV viremia or mucosal virus shedding in pigtail macaques

Radzio

Hanley

Mitchell³

et al. 2014

Aids

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Section: Discussionmentioning

confidence: 49%

Physiologic doses of depot-medroxyprogesterone acetate do not increase acute plasma simian HIV viremia or mucosal virus shedding in pigtail macaques

Radzio

Hanley

Mitchell³

et al. 2014

Aids

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“…There is a need for all HIV-positive persons to access care and preventive interventions in a timely manner (UNAIDS 2013;Mermin et al 2006;Graham et al 2010;Granich et al 2010) to prevent morbidity and mortality (Amuron et al 2009;Losina et al 2010;Bassett et al 2009). However, uptake of free HIV care services after diagnosis remains suboptimal.…”

Section: Introductionmentioning

confidence: 99%

Barriers to Utilization of HIV Care Services Among Adolescents and Young Adults in Rakai, Uganda: the Role of Economic Strengthening

et al. 2015

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Background Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, adolescents and young adults 15-24 years were at increased risk of not entering care after knowledge of their positive HIV status. This qualitative study explored barriers to entry into care from HIV-positive clients aged 15-24 years and explored the role of economic strengthening in promoting care utilization. Methods We conducted 18 in-depth interviews among HIVinfected individuals aged 15-24 years, who had not entered care within 6 months of result receipt and referral for free care. Also, key informant interviews were conducted with 12 providers. Interviews were audio-recorded and transcripts subjected to thematic content analysis based on the health belief model. Results Barriers to using HIV care included fear of stigma (7/18−39 %) and HIV disclosure and high transport costs. Programmatic barriers included fear of antiretroviral drug side effects, long waiting, and travel times. Denial of HIV status and absence of AIDS symptoms were also barriers. Eight (44 %) of the participants reported economic barriers to care utilization, and these included lack of money for transport to clinic and anticipated lost work time and money resulting from long waiting clinic hours. Conclusion Economic barriers are highly prevalent as obstacles to utilization of care by young people, suggesting the role of economic strengthening for young persons living with HIV, so as to promote utilization of HIV care services.

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“…5 Recent studies have indicated that universal testing and appropriately prescribed ART for HIV-infected persons would not only benefit the individual but would substantially decrease HIV transmissions by decreasing HIV viral load in the community. 6,7 A recent clinical trial, HPTN 052, showed that early initiation of ART significantly reduces HIV transmission to a partner. 8 For the full benefits of these "test and treat" strategies to be realized, HIV-infected persons must enter care and take ART as prescribed before they experience symptoms.…”

Section: Introductionmentioning

confidence: 99%

Medication-Related Barriers to Entering HIV Care

Beer

Fagan²,

Garland³

et al. 2012

AIDS Patient Care and STDs

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Early entry to HIV care and receipt of antiretroviral therapy improve the health of the individual and decrease the risk of transmission in the community. To increase the limited information on prospective decisions to enter care and how these decisions relate to beliefs about HIV medications, we analyzed interview data from the Never in Care Project, a multisite project conducted in Indiana, New Jersey, New York City, Philadelphia, and Washington State. From March 2008 through August 2010, we completed structured interviews with 134 persons with no evidence of HIV care entry, 48 of whom also completed qualitative interviews. Many respondents believed that HIV care entails the passive receipt of medications that may be harmful or unnecessary, resulting in reluctance to enter care. Respondents voiced concerns about prescription practices and preserving future treatment options, mistrust of medications and medical care providers, and ambivalence about the life-preserving properties of medications in light of an assumed negative impact on quality of life. Our results support the provision of information on other benefits of care (beyond medications), elicitation of concerns about medications, and assessment of psychosocial barriers to entering care. These tasks should begin at the time a positive test result is delivered and continue throughout the linkage-to-care process; for persons unwilling to enter care immediately, support should be provided in nonmedical settings.

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Antiretroviral Adherence and Development of Drug Resistance Are the Strongest Predictors of Genital HIV‐1 Shedding among Women Initiating Treatment

Cited by 46 publications

References 13 publications

Physiologic doses of depot-medroxyprogesterone acetate do not increase acute plasma simian HIV viremia or mucosal virus shedding in pigtail macaques

Physiologic doses of depot-medroxyprogesterone acetate do not increase acute plasma simian HIV viremia or mucosal virus shedding in pigtail macaques

Barriers to Utilization of HIV Care Services Among Adolescents and Young Adults in Rakai, Uganda: the Role of Economic Strengthening

Medication-Related Barriers to Entering HIV Care

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