True Durability: HIV Virologic Suppression in an Urban Clinic and Implications for Timing of Intensive Adherence Efforts and Viral Load Monitoring

Benator, Debra; Elmi, Angelo; Rodríguez, Manuel de Buenaga; Gale, Howard B.; Kan, Virginia L.; Hoffman, Heather J.; Tramazzo, Susan; Hall, Karen E.; McKnight, Angela; Squires, Leah

doi:10.1007/s10461-014-0917-6

Cited by 22 publications

(18 citation statements)

References 20 publications

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“…Antiretroviral therapy (ART) is an essential component of HIV prevention and treatment, and is the single most important factor in achieving undetectable viral loads (Flynn et al, 2004). In addition to viral suppression, ART adherence is correlated with reductions in hospitalizations (Paterson et al, 2000), mortality (Lima et al, 2009), slowed HIV disease progression (Benator et al, 2015), and improved quality of life (Burman et al, 2008). There are also important public health implications.…”

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confidence: 99%

An Exploration of Syndemic Factors That Influence Engagement in HIV Care Among Black Men

et al. 2018

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Syndemic theory seeks to understand the interactions and clustering of disease and social conditions and explain racial disparities in HIV. Traditionally applied to HIV risk, this study characterizes the syndemic challenges of engagement in care among Black men living with HIV and provides insight into potential HIV treatment interventions to retain vulnerable individuals in care. Interviews were conducted with 23 HIV-positive men who were either out-of-care or non-adherent to antiretroviral therapy. Interviews were audio-recorded, transcribed verbatim, and coded using MAXQDA qualitative software. Researchers analyzed data using thematic content analysis to identify syndemic factors associated with disengagement in care or suboptimal ART adherence among Black men. Analyses revealed the syndemic nature of 4 themes: intersectional stigma, depression, substance use, and poverty. Findings from this study offer numerous opportunities for intervention including social and structural-level interventions to address syndemic processes and the influence of stigma and poverty on engagement in care.

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confidence: 99%

An Exploration of Syndemic Factors That Influence Engagement in HIV Care Among Black Men

et al. 2018

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“…2 Such disparities necessitate effective interventions to improve prevention and treatment of HIV among YBMSM. HIV antiretroviral therapy (ART) is an essential component of HIV prevention 3,4 and treatment 5,6 and the single most important factor in achieving undetectable viral loads in people living with HIV. 7 In addition to viral suppression, ART adherence is also correlated with reductions in hospitalizations 8 and mortality, 6,9,10 slowed HIV disease progression, 5,11,12 and improved quality of life.…”

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confidence: 99%

A Longitudinal Analysis of Antiretroviral Adherence Among Young Black Men Who Have Sex With Men

Voisin

Quinn

Kim

et al. 2017

Journal of Adolescent Health

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HIV-positive young Black MSM (YBMSM) experience poor antiretroviral (ART) medication adherence relative to their white counterparts. However, few studies have longitudinally examined factors that may correlate with various classifications of ART adherence among this population, which was the primary aim of this study. Project nGage was a randomized controlled trial conducted across five Chicago clinics from 2012–2015. Survey and medical records data were collected at baseline, 3-, and 12-month periods to assess psychological distress, HIV stigma, substance use, family acceptance, social support and self efficacy predicted ART medication adherence among 92 YBMSM ages 16 to 29 years old. Major results controlling for the potential effects of age, education level, employment, and intervention condition, indicated that participants with high versus low medication adherence were less likely to report daily/weekly alcohol or marijuana use, have higher family acceptance, and greater self efficacy. These findings identity important constructs that can be targeted in clinical and program interventions which correlate with improved ART medication adherence for YBMSM.

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“…In these settings, HIV viral load testing is targeted rather than routine to confirm treatment failure, but potential delays in treatment switching can increase the risk of disease progression, drug resistance and HIV transmission (Arnedo et al, 2012; Kanapathipillai et al, 2011; Nettles et al, 2005). With the increasing use of regimens beyond first-line, there are strong clinical benefits for routine HIV viral load testing in RLS to prevent unnecessary treatment switching, identify treatment failure early to facilitate switch and avoid accumulation of resistance mutations, and guide adherence interventions (Benator et al, 2015; Bonner, Mezochow, Roberts, Ford, & Cohn, 2013; Keiser et al, 2011; Sigaloff et al, 2011). In future years, efforts should be made to provide HIV viral load testing that is affordable and easier to use for HIV programmes in RLS (Calmy et al, 2007).…”

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confidence: 99%

Growing challenges for HIV programmes in Asia: clinic population trends, 2003–2013

Mata¹,

Kumarasamy

et al. 2017

AIDS Care

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The scale-up of antiretroviral therapy (ART) has led to a substantial change in the clinical population of HIV-positive patients receiving care. We describe the temporal trends in the demographic and clinical characteristics of HIV-positive patients initiating ART in 2003–13 within an Asian regional cohort. All HIV-positive adult patients that initiated ART between 2003 and 2013 were included. We summarized ART regimen use, age, CD4 cell count, HIV viral load, and HIV-related laboratory monitoring rates during follow-up by calendar year. A total of 16 962 patients were included in the analysis. Patients in active follow-up increased from 695 patients at four sites in 2003 to 11,137 patients at eight sites in 2013. The proportion of patients receiving their second or third ART regimen increased over time (5% in 2003 to 29% in 2013) along with patients aged ≥50 years (8% in 2003 to 18% in 2013). Concurrently, CD4 monitoring has remained stable in recent years, whereas HIV viral load monitoring, although varied among the sites, is increasing. There have been substantial changes in the clinical and demographic characteristics of HIV-positive patients receiving ART in Asia. HIV programmes will need to anticipate the clinical care needs for their aging populations, expanded viral load monitoring, and, the eventual increase in second and third ART regimens that will lead to higher costs and more complex drug procurement needs.

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True Durability: HIV Virologic Suppression in an Urban Clinic and Implications for Timing of Intensive Adherence Efforts and Viral Load Monitoring

Cited by 22 publications

References 20 publications

An Exploration of Syndemic Factors That Influence Engagement in HIV Care Among Black Men

An Exploration of Syndemic Factors That Influence Engagement in HIV Care Among Black Men

A Longitudinal Analysis of Antiretroviral Adherence Among Young Black Men Who Have Sex With Men

Growing challenges for HIV programmes in Asia: clinic population trends, 2003–2013

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