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The HIV care continuum in Latin America: challenges and opportunities

Summary Combination antiretroviral therapy (ART), also known as highly active antiretroviral therapy, provides clinical and immunological benefits for people living with HIV and is an effective strategy to prevent HIV transmission at the individual level. Early initiation of ART as part of a test an... Full description

Journal Title: The Lancet infectious diseases 2015, Vol.15 (7), p.833-839
Main Author: Piñeirúa, Alicia, MD
Other Authors: Sierra-Madero, Juan, MD , Cahn, Pedro, MD , Guevara Palmero, Rafael Napoleón, MD , Martínez Buitrago, Ernesto, MD , Young, Benjamin, Dr , Del Rio, Carlos, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
HIV
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Ltd
ID: ISSN: 1473-3099
Link: https://www.ncbi.nlm.nih.gov/pubmed/26122456
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recordid: cdi_proquest_miscellaneous_1692754609
title: The HIV care continuum in Latin America: challenges and opportunities
format: Article
creator:
  • Piñeirúa, Alicia, MD
  • Sierra-Madero, Juan, MD
  • Cahn, Pedro, MD
  • Guevara Palmero, Rafael Napoleón, MD
  • Martínez Buitrago, Ernesto, MD
  • Young, Benjamin, Dr
  • Del Rio, Carlos, Prof
subjects:
  • Acquired immune deficiency syndrome
  • AIDS
  • Antiretroviral drugs
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • Continuity of Patient Care
  • Disease transmission
  • Drug therapy
  • Early Diagnosis
  • Epidemics
  • HIV
  • HIV Infections - diagnosis
  • HIV Infections - drug therapy
  • HIV Infections - epidemiology
  • HIV Infections - immunology
  • Human immunodeficiency virus
  • Humans
  • Infectious Disease
  • Latin America - epidemiology
  • Medical tests
  • Prenatal care
  • Prevalence
  • Viral Load
  • Womens health
ispartof: The Lancet infectious diseases, 2015, Vol.15 (7), p.833-839
description: Summary Combination antiretroviral therapy (ART), also known as highly active antiretroviral therapy, provides clinical and immunological benefits for people living with HIV and is an effective strategy to prevent HIV transmission at the individual level. Early initiation of ART as part of a test and treat approach might decrease HIV transmission at the population level, but to do so the HIV continuum of care, from diagnosis to viral suppression, should be optimised. Access to ART has improved greatly in Latin America, and about 600 000 people are on treatment. However, health-care systems are deficient in different stages of the HIV continuum of care, and in some cases only a small proportion of individuals achieve the desired outcome of virological suppression. At present, data for most Latin American countries are not sufficient to build reliable metrics. Available data and estimates show that many people living with HIV in Latin America are unaware of their status, are diagnosed late, and enter into care late. Stigma, administrative barriers, and economic limitations seem to be important determinants of late diagnosis and failure to be linked to and retained in care. Policy makers need reliable data to optimise the HIV care continuum and improve individual-based and population-based outcomes of ART in Latin America.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1473-3099
fulltext: fulltext
issn:
  • 1473-3099
  • 1474-4457
url: Link


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descriptionSummary Combination antiretroviral therapy (ART), also known as highly active antiretroviral therapy, provides clinical and immunological benefits for people living with HIV and is an effective strategy to prevent HIV transmission at the individual level. Early initiation of ART as part of a test and treat approach might decrease HIV transmission at the population level, but to do so the HIV continuum of care, from diagnosis to viral suppression, should be optimised. Access to ART has improved greatly in Latin America, and about 600 000 people are on treatment. However, health-care systems are deficient in different stages of the HIV continuum of care, and in some cases only a small proportion of individuals achieve the desired outcome of virological suppression. At present, data for most Latin American countries are not sufficient to build reliable metrics. Available data and estimates show that many people living with HIV in Latin America are unaware of their status, are diagnosed late, and enter into care late. Stigma, administrative barriers, and economic limitations seem to be important determinants of late diagnosis and failure to be linked to and retained in care. Policy makers need reliable data to optimise the HIV care continuum and improve individual-based and population-based outcomes of ART in Latin America.
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subjectAcquired immune deficiency syndrome ; AIDS ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Continuity of Patient Care ; Disease transmission ; Drug therapy ; Early Diagnosis ; Epidemics ; HIV ; HIV Infections - diagnosis ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - immunology ; Human immunodeficiency virus ; Humans ; Infectious Disease ; Latin America - epidemiology ; Medical tests ; Prenatal care ; Prevalence ; Viral Load ; Womens health
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abstractSummary Combination antiretroviral therapy (ART), also known as highly active antiretroviral therapy, provides clinical and immunological benefits for people living with HIV and is an effective strategy to prevent HIV transmission at the individual level. Early initiation of ART as part of a test and treat approach might decrease HIV transmission at the population level, but to do so the HIV continuum of care, from diagnosis to viral suppression, should be optimised. Access to ART has improved greatly in Latin America, and about 600 000 people are on treatment. However, health-care systems are deficient in different stages of the HIV continuum of care, and in some cases only a small proportion of individuals achieve the desired outcome of virological suppression. At present, data for most Latin American countries are not sufficient to build reliable metrics. Available data and estimates show that many people living with HIV in Latin America are unaware of their status, are diagnosed late, and enter into care late. Stigma, administrative barriers, and economic limitations seem to be important determinants of late diagnosis and failure to be linked to and retained in care. Policy makers need reliable data to optimise the HIV care continuum and improve individual-based and population-based outcomes of ART in Latin America.
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