Viral-load Point-of-Care Technologies to Achieve an AIDS-Free Generation

Cogswell, Heather A; Ohadi, Elizabeth; Ávila, Carlos

doi:10.2217/fmb.15.121

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…Despite the development of several POC viral load technologies over the last decade (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), there is a shortage of commercially available tests. In this study, we evaluated the performance of the POC Cepheid Xpert HIV-1 viral load test in rural communities in Botswana in order to provide additional data to policy makers regarding the use of this assay in decentralized HIV treatment programs.…”

mentioning

confidence: 99%

Point-of-Care Cepheid Xpert HIV-1 Viral Load Test in Rural African Communities Is Feasible and Reliable

et al. 2016

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mentioning

confidence: 99%

Point-of-Care Cepheid Xpert HIV-1 Viral Load Test in Rural African Communities Is Feasible and Reliable

et al. 2016

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“…Results should not be interpreted as causal, and there is potential for reverse directionality between recent incarceration and the mediators. Clinical measures of HIV viral load are often regarded as the gold standard in measuring HIV health (Cogswell et al, 2016) and used as a hard marker for ART adherence. Despite this, however, the specific purpose of this study was not to look at HIV viral load but rather to investigate the mechanisms that might influence participants' ability to maintain optimal adherence in the postrelease period.…”

Section: Discussionmentioning

confidence: 99%

Pathways From Recent Incarceration to Antiretroviral Therapy Adherence: Opportunities for Interventions to Support Women Living With HIV Post Release From Correctional Facilities

Erickson¹,

Krüsi²,

Shannon³

et al. 2022

J Assoc Nurses AIDS Care

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Women living with HIV are increasingly incarcerated and experience suboptimal HIV health outcomes post release from incarceration. Drawing on cohort data with cisgender and trans women living with HIV (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment), we used path analysis to investigate pathways from recent incarceration to optimal antiretroviral therapy (ART) adherence. We tested direct effects between recent incarceration, mediating variables, and ART adherence, along with indirect effects between incarceration and ART adherence through each mediator. We assessed model fit using chi-square, root-mean-square error of approximation (RMSEA), and comparative fit index (CFI). Our hypothesized model fit well to the data (χ2(1)=1.100; p=.2943; CFI = 1.000; RMSEA = 0.007). Recent experiences of homelessness, criminalized substance use, and gender-based violence each fully mediated the pathway between recent incarceration and optimal ART adherence. Findings highlight the need for safe and supportive housing, supports for criminalized substance use, and trauma and violence–informed care and practice post release from incarceration.

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“…Patients with suppressed viral load would require less frequent monitoring, freeing providers to focus on patients with unsuppressed viral load, promoting adherence and allowing timely switching to second-line regimens (17). Utilizing point-of-care viral load testing technology can also help make care more patient-centric by enabling more timely results delivery and improved adherence support (18). By adopting these or similar models of care based on viral load status and targeting the areas of ARV dispensing, service delivery, or lab monitoring, Botswana could more accurately allocate resources based on patient needs, leading to reduced costs and improved efficiency of care, particularly for stable, asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

Efficiency of health facilities providing antiretroviral treatment services in Botswana

Ávila¹,

Zeng²,

Cintron³

2020

J Hosp Manag Health Policy

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Background: Botswana is implementing an ambitious universal health coverage agenda and successfully expanding antiretroviral treatment to nearly 380,000 people living with human immunodeficiency virus (HIV). However, the country needs to critically assess its efficient use of all available resources to sustain gains and continue progress to attain the targets and vision for ending acquired immune deficiency syndrome (AIDS) as a public health threat by 2030. The objective of this study was to measure costs and efficiency of antiretroviral therapy (ART) provision in Botswana's public facilities, and to identify opportunities for potential savings in order to expand ART coverage. Methods:We applied an activity-based costing approach to a random sample of 2,393 adults receiving ART outpatient services in 120 facilities in Botswana. All costs are reported in 2017 US$. We defined efficiency as the amount of resources that is put into the delivery of healthcare in relation to the amount of people receiving services. Employing a health systems perspective, the production of antiretroviral healthcare services includes three major inputs: labor, antiretroviral drugs and laboratory tests. The production unit was defined as an ART clinical unit running in a hospital, primary health care (PHC) clinic, or health post.Data envelopment analysis (DEA) was used to identify the most efficient facilities and regression analysis to identify factors associated with technical efficiency.

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Viral-load Point-of-Care Technologies to Achieve an AIDS-Free Generation

Cited by 5 publications

References 9 publications

Point-of-Care Cepheid Xpert HIV-1 Viral Load Test in Rural African Communities Is Feasible and Reliable

Point-of-Care Cepheid Xpert HIV-1 Viral Load Test in Rural African Communities Is Feasible and Reliable

Pathways From Recent Incarceration to Antiretroviral Therapy Adherence: Opportunities for Interventions to Support Women Living With HIV Post Release From Correctional Facilities

Efficiency of health facilities providing antiretroviral treatment services in Botswana

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