Evaluating the care cascade after antiretroviral therapy initiation in Latin America
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/25473 |
Resumo: | 2019-01-31 |
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Wolff, Marcelo J.Cortes, Claudia P.Mejìa, Fernando A.Padgett, DenisBelaunzarán-Zamudio, PabloGrinsztejn, BeatrizGiganti, Mark J.McGowan, Catherine C.Rebeiro, Peter F2018-03-23T15:06:28Z2018-03-23T15:06:28Z2018WOLFF, Marcelo J. et al. Evaluating the care cascade after antiretroviral therapy initiation in Latin America. International Journal of STD and AIDS, v. 29, n. 1, p. 4-12, Jan. 2018.0956-4624https://www.arca.fiocruz.br/handle/icict/2547310.1177/0956462417714094engSAGEEvaluating the care cascade after antiretroviral therapy initiation in Latin Americainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2019-01-31University of Chile. Fundacion Arriaran. School of Medicine. Santiago, Chile.University of Chile. Fundacion Arriaran. School of Medicine. Santiago, Chile.Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.Instituto Hondureño de Seguridad Social and Hospital Escuela Universitario. Tegucigalpa, Honduras.Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico / Universidad Nacional Autónoma de México. División de Investigación de Facultad de Medicina. Mexico City, Mexico.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brasil.Vanderbilt University School of Medicine. Nashville, TN, USA.Vanderbilt University School of Medicine. Nashville, TN, USA.Vanderbilt University School of Medicine. Nashville, TN, USA.Accelerating antiretroviral therapy (ART) administration, improving retention, and achieving viral suppression in low- and middle-income countries must be prioritized. We evaluated trends and disparities in these milestones in a large Latin American cohort. Adults starting ART (ARTstart) from 2003 to 2014 at Caribbean, Central, and South America network for HIV epidemiology sites were assessed for care cascade outcomes: CD4 cell count >200 cells/mm3at ARTstart; retention (≥1 visit at one year after ARTstart); viral suppression (≥1 HIV-1 RNA <200 copies/ml at one year after ARTstart). Modified Poisson regression provided adjusted prevalence ratios by age, gender, and HIV transmission risk, accounting for site and year of ARTstart. Proportions achieving ARTstartand suppression improved over time (p < 0.05). Older age was associated with better retention and viral suppression, but not ARTstartat CD4 cell count >200 cells/mm3. Females and men who have sex with men (MSM) were more likely to have CD4 cell count >200 cells/mm3at ARTstart. Injection drug users (IDUs) were less likely to be retained while MSM were more likely to achieve viral suppression (all p < 0.05). Despite improvements in these outcomes over the course of a decade in this cohort, significant disparities existed, disadvantaging younger patients, men, and IDUs. These gaps indicate continued progress in providing early diagnosis and ARTstartremain critical.HIVSouth AmericaAIDSEpidemiologyARTHomosexualMinorias SexuaisSíndrome de Imunodeficiência AdquiridaEpidemiologiaAmérica do Sulinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/25473/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALEvaluating the care cascade after antiretroviral therapy initiation in Latin America.pdfEvaluating the care cascade after antiretroviral therapy initiation in Latin America.pdfapplication/pdf342070https://www.arca.fiocruz.br/bitstream/icict/25473/2/Evaluating%20the%20care%20cascade%20after%20antiretroviral%20therapy%20initiation%20in%20Latin%20America.pdfd6bd7a5822fc1e4904815f6a46add746MD52TEXTEvaluating the care cascade after antiretroviral therapy initiation in 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dc.title.pt_BR.fl_str_mv |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America |
title |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America |
spellingShingle |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America Wolff, Marcelo J. HIV South America AIDS Epidemiology ART Homosexual Minorias Sexuais Síndrome de Imunodeficiência Adquirida Epidemiologia América do Sul |
title_short |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America |
title_full |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America |
title_fullStr |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America |
title_full_unstemmed |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America |
title_sort |
Evaluating the care cascade after antiretroviral therapy initiation in Latin America |
author |
Wolff, Marcelo J. |
author_facet |
Wolff, Marcelo J. Cortes, Claudia P. Mejìa, Fernando A. Padgett, Denis Belaunzarán-Zamudio, Pablo Grinsztejn, Beatriz Giganti, Mark J. McGowan, Catherine C. Rebeiro, Peter F |
author_role |
author |
author2 |
Cortes, Claudia P. Mejìa, Fernando A. Padgett, Denis Belaunzarán-Zamudio, Pablo Grinsztejn, Beatriz Giganti, Mark J. McGowan, Catherine C. Rebeiro, Peter F |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Wolff, Marcelo J. Cortes, Claudia P. Mejìa, Fernando A. Padgett, Denis Belaunzarán-Zamudio, Pablo Grinsztejn, Beatriz Giganti, Mark J. McGowan, Catherine C. Rebeiro, Peter F |
dc.subject.en.pt_BR.fl_str_mv |
HIV South America AIDS Epidemiology ART Homosexual |
topic |
HIV South America AIDS Epidemiology ART Homosexual Minorias Sexuais Síndrome de Imunodeficiência Adquirida Epidemiologia América do Sul |
dc.subject.decs.pt_BR.fl_str_mv |
Minorias Sexuais Síndrome de Imunodeficiência Adquirida Epidemiologia América do Sul |
description |
2019-01-31 |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-03-23T15:06:28Z |
dc.date.available.fl_str_mv |
2018-03-23T15:06:28Z |
dc.date.issued.fl_str_mv |
2018 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
WOLFF, Marcelo J. et al. Evaluating the care cascade after antiretroviral therapy initiation in Latin America. International Journal of STD and AIDS, v. 29, n. 1, p. 4-12, Jan. 2018. |
dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/25473 |
dc.identifier.issn.pt_BR.fl_str_mv |
0956-4624 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.1177/0956462417714094 |
identifier_str_mv |
WOLFF, Marcelo J. et al. Evaluating the care cascade after antiretroviral therapy initiation in Latin America. International Journal of STD and AIDS, v. 29, n. 1, p. 4-12, Jan. 2018. 0956-4624 10.1177/0956462417714094 |
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https://www.arca.fiocruz.br/handle/icict/25473 |
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eng |
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eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
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SAGE |
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SAGE |
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