Health services and systems

Health services and systems features

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  Policy makers’ inaction is leading people to take PrEP ‘in the wild’

  An increasing number of gay men and others at risk of HIV are seeking to protect their health with PrEP (pre-exposure prophylaxis), but the lack of...

  From:  News

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  Sweden the first country to achieve UNAIDS/WHO 90-90-90 target

  Sweden has become the first country to achieve the UNAIDS/World Health Organization (WHO) 90-90-90 target, research published in HIV Medicine shows. At the end of 2015, 90% of...

  From:  News

• Geriatric HIV: living with multiple medical conditions will become the norm as population ages

  In fifteen years' time, the clinical needs of Dutch people living with HIV will have changed substantially due to three quarters of them being over the...

  From:  News

• No improvements in CD4 count at diagnosis in African patients in last decade

  A study by Harvard Medical School has found that the average CD4 count in sub-Saharan African people who are diagnosed with HIV has not risen since 2002....

  From:  News

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  Of guidelines, targets and resources: the documents that defined the 2014 International AIDS Conference

  If there was a phrase that defined the 20th International AIDS Conference (AIDS 2014), one that surfaced in every few presentations and kept turning up in documents,...

  From:  News

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  All change...

  As part of the last-ever HIV treatment update, Gus Cairns asked a number of prominent activists, movers and shakers in the world of HIV care and prevention in...

  From:  HIV treatment update

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  Multi-disease prevention campaigns (part 2): case studies from Kenya and Uganda

  Following on from the previous edition, this article examines in more detail two campaign approaches to multi-disease prevention that included HIV....

  From:  HIV & AIDS treatment in practice

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  Multi-disease prevention campaigns (part 1): integrating HIV into wider public health campaigns

  This edition examines the concept of multi-disease prevention campaigns targeting a range of public health issues in a concentrated burst of activity in a locality....

  From:  HIV & AIDS treatment in practice

• Evidence is not yet sufficient to recommend universal treatment, clinicians and community writers say

  We do not yet have sufficiently strong evidence to recommend that antiretroviral treatment (ART) should be offered to all people with HIV, regardless of their CD4 count, a...

  From:  News

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  Xpert MTB/RIF diagnostic test for TB: a global update

  This article reviews recent implementation research on the new TB diagnostic Xpert MTB/RIF....

  From:  HIV & AIDS treatment in practice

Health services and systems in your own words

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  Going into hospital

  My experiences of hospitalisation are mixed. I’ve been admitted twice in the last six months, both times for a minor operation. However, following the excellent...

  From: In your own words

Health services and systems news from aidsmap

• What challenges must Nigeria overcome to eliminate vertical transmission of HIV?

  Despite impressive health system-related achievements in the prevention of mother-to-child transmission of HIV (PMTCT) in the last decade, Nigeria contributes the greatest number of infants infected with HIV worldwide. Elimination of mother-to-child transmission of HIV in ...

  20 June 2019 | Carole Leach-Lemens

• High prevalence of stockouts of antiretroviral medicines in South Africa

  One in five public health facilities in South Africa were unable to supply at least one antiretroviral (ARV) or tuberculosis (TB) drug on the day they were contacted by researchers, while over a third had had a drug stockout in ...

  23 May 2019 | Alain Volny-Anne

• Rapid rehousing support for homeless people living with HIV improves housing and HIV outcomes

  Homeless people with HIV who are provided with rapid rehousing and intensive, tailored case management are placed in stable housing more quickly and are twice as likely to be virally suppressed when compared to individuals receiving standard homelessness support, according ...

  17 May 2019 | Michael Carter

• Why has the uptake of lopinavir/ritonavir oral pellets for children been slow?

  Lopinavir/ritonavir (LPV/r) oral pellets and oral granules for infants and young children living with HIV have proven advantages in terms of efficacy and tolerability over other formulations of LPV/r, but uptake has been slow in low- and middle-income countries with ...

  02 May 2019 | Carole Leach-Lemens

• EACS Standard of Care meeting report – Tackling HIV and co-infections in Europe: towards common standards

  This is the full report from the EACS Standard of Care Meeting. It can also be read in three separate sections here.Eastern Europe continues to have one of the few HIV epidemics in the world where HIV incidence ...

  29 March 2019 | Gus Cairns

• Non-adherence to HIV treatment for cost-saving reasons reported by 8% in American study

  Much of the excessive cost of prescription drugs in the United States falls on patients, and national surveillance data has now found that this has a real impact on HIV treatment outcomes. A study presented at the Conference on Retroviruses ...

  27 March 2019 | Roger Pebody

• Multiple benefits to scaling up universal test and treat in Africa

  As well as the important findings of PopART, the largest HIV prevention trial ever conducted, this week’s Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle heard about several other studies from African countries which have scaled up universal testing ...

  08 March 2019 | Roger Pebody

• HIV infections lowered by 30% in universal testing and treatment study

  Communities in southern Africa which received a door-to-door HIV testing intervention and support for linkage to care had substantially lower HIV incidence, the Conference on Retroviruses and Opportunistic Infections (CROI 2019) in Seattle was told today.This clear-cut effect was ...

  06 March 2019 | Roger Pebody

• Point-of-care viral load testing improves treatment outcomes and retention in care

  Same-day provision of results from a point-of-care viral load test – rather than waiting weeks for laboratory results to be collected – resulted in a 14% improvement in virological suppression and retention in care in a public clinic in ...

  05 March 2019 | Roger Pebody

• Tackling HIV and hepatitis C in Europe: towards minimum standards

  Despite the huge disparities in care that were highlighted, last week's Standard of Care for HIV and Coinfections in Europe meeting in Bucharest featured discussions that could form the basis of a European-wide exercise to audit HIV centres to a ...

  08 February 2019 | Gus Cairns

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Health services and systems news selected from other sources

• Adults with HIV who have compassionate care providers start and remain in treatment longer

  Researchers find patients who perceive their primary care providers as lacking empathy and not willing to include them in decision making are at risk for abandoning treatment or not seeking treatment at all.

  15 July 2019 | ScienceDaily

• 1 in 10 People With Diagnosed HIV Must Drive Over 1 Hour for Care

  Such lengthy commutes for HIV care among those with diagnosed with the virus may impede efforts to control the epidemic.

  20 June 2019 | Poz

• For People With HIV, Health Coverage Is Improving

  A new analysis finds that Obamacare has driven down the proportion of individuals without insurance.

  19 June 2019 | Poz

• USPSTF Recommendation for PrEP: Reflections on Insurance Coverage and HIV Prevention for Older Adults

  An “A” letter grade indicates that the panel recommends the service and finds there is high certainty that the service has a substantial net benefit. This recommendation will help improve access to PrEP by urging health care providers to offer PrEP to people at risk for HIV. It will also trigger statutory coverage requirements for health plans and create other opportunities for making PrEP more affordable.

  17 June 2019 | O'Neill Institute

• US: HIV Advocacy Group Spars With Express Scripts Over HIV Drug Formulary Changes

  Express Scripts, one of the largest pharmacy benefit managers (PBMs) in the U.S., recently updated its list of preferred medicines to exclude seven common HIV drugs, swapping those drugs for 18 "preferred alternatives."

  17 June 2019 | The BodyPro

• Ireland: HIV programme ‘will be undermined’ by lack of capacity

  Thousands of people are being turned away from sexual health clinics across the Republic, which will undermine a programme for preventing HIV due to be introduced later this year, according to Fianna Fáil. The PrEP (pre-exposure prophylaxis) HIV prevention programme is being implemented by the Government following advice from the State’s health watchdog that it would be safe and cost-effective.

  17 June 2019 | Irish Times

• Community based adherence clubs have higher drop-out rates than those based in clinics

  Differentiated care models need further investigation to support people living with HIV with taking their antiretroviral treatment (ART).

  07 June 2019 | Avert

• This drug could end HIV. Why hasn't it? (Podcast)

  Dr. Robert Grant developed a treatment — a daily pill known as pre-exposure prophylaxis, or PrEP — that could stop the AIDS crisis. We look at why that hasn’t happened.

  06 June 2019 | New York Times

• I Moved Back to Atlanta from Boston, and I've Been Out of HIV Meds for a Month

  HIV care is separate and unequal in America, health activist Mason writes, as "the system of care here feels no urgency around my survival."

  04 June 2019 | The Body

• US: Nearly 1 in 5 People Living With HIV Have Suboptimal Geographic Access to HIV Care

  Nearly 10% of people living with HIV have to travel more than an hour to access HIV care, and those living in rural counties have drive times more than double that of those in urban counties.

  03 June 2019 | American Journal of Managed Care

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