Universidad Peruana Cayetano Heredia

Evaluating the care cascade after antiretroviral therapy initiation in Latin America

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dc.contributor.author Wolff, M. J.
dc.contributor.author Cortes, C. P.
dc.contributor.author Mejía Cordero, Fernando Alonso
dc.contributor.author Padgett, D.
dc.contributor.author Belaunzarán-Zamudio, P.
dc.contributor.author Grinsztejn, B.
dc.contributor.author Giganti, M. J.
dc.contributor.author McGowan, C. C.
dc.contributor.author Rebeiro, P. F.
dc.date.accessioned 2018-03-22T23:38:49Z
dc.date.available 2018-03-22T23:38:49Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/1472
dc.description.abstract 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/mm3 at 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 ARTstart and suppression improved over time (p < 0.05). Older age was associated with better retention and viral suppression, but not ARTstart at 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/mm3 at 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 ARTstart remain critical. en_US
dc.language.iso eng
dc.publisher SAGE Publications
dc.relation.ispartofseries International Journal of STD and AIDS
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject HIV en_US
dc.subject AIDS en_US
dc.subject Epidemiology en_US
dc.subject ART en_US
dc.subject HIV en_US
dc.subject homosexual en_US
dc.subject South America en_US
dc.title Evaluating the care cascade after antiretroviral therapy initiation in Latin America en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1177/0956462417714094
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.06.02
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.12
dc.relation.issn 1758-1052


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