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Assessing the HIV Care Continuum in Latin America: progress in clinical retention, cART use and viral suppression

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dc.contributor.author Rebeiro, Peter-F.
dc.contributor.author Cesar, Carina
dc.contributor.author Shepherd, Bryan-E.
dc.contributor.author De-Boni, Raquel-B.
dc.contributor.author Cortes, Claudia-P.
dc.contributor.author Rodriguez, Fernanda
dc.contributor.author Belaunzaran-Zamudio, Pablo
dc.contributor.author Pape, Jean-W.
dc.contributor.author Padgett, Denis
dc.contributor.author Hoces, Daniel
dc.contributor.author McGowan, Catherine-C.
dc.contributor.author Cahn, Pedro
dc.date.accessioned 2019-02-06T14:45:58Z
dc.date.available 2019-02-06T14:45:58Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5151
dc.description.abstract INTRODUCTION: We assessed trends in HIV Care Continuum outcomes associated with delayed disease progression and reduced transmission within a large Latin American cohort over a decade: clinical retention, combination antiretroviral therapy (cART) use and viral suppression (VS). METHODS: Adults from Caribbean, Central and South America network for HIV epidemiology clinical cohorts in seven countries contributed data between 2003 and 2012. Retention was defined as two or more HIV care visits annually, >90 days apart. cART was defined as prescription of three or more antiretroviral agents annually. VS was defined as HIV-1 RNA <200 copies/mL at last measurement annually. cART and VS denominators were subjects with at least one visit annually. Multivariable modified Poisson regression was used to assess temporal trends and examine associations between age, sex, HIV transmission mode, cohort, calendar year and time in care. RESULTS: Among 18,799 individuals in retention analyses, 14,380 in cART analyses and 13,330 in VS analyses, differences existed between those meeting indicator definitions versus those not by most characteristics. Retention, cART and VS significantly improved from 2003 to 2012 (63 to 77%, 74 to 91% and 53 to 82%, respectively; p<0.05, each). Female sex (risk ratio (RR)=0.97 vs. males) and injection drug use as HIV transmission mode (RR=0.83 vs. male sexual contact with males (MSM)) were significantly associated with lower retention, but unrelated with cART or VS. MSM (RR=0.96) significantly decreased the probability of cART compared with heterosexual transmission. CONCLUSIONS: HIV Care Continuum outcomes improved over time in Latin America, though disparities for vulnerable groups remain. Efforts must be made to increase retention, cART and VS, while engaging in additional research to sustain progress in these settings. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof urn:issn:1758-2652
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Continuity of Patient Care en_US
dc.subject Adult en_US
dc.subject Anti-HIV Agents/administration & dosage en_US
dc.subject cART use en_US
dc.subject CD4 Lymphocyte Count en_US
dc.subject cohort studies en_US
dc.subject Drug Therapy, Combination en_US
dc.subject Female en_US
dc.subject HIV Care Continuum en_US
dc.subject HIV Infections/drug therapy/transmission/virology en_US
dc.subject Humans en_US
dc.subject Latin America en_US
dc.subject Male en_US
dc.subject retention en_US
dc.subject Viral Load en_US
dc.subject viral suppression en_US
dc.title Assessing the HIV Care Continuum in Latin America: progress in clinical retention, cART use and viral suppression en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.7448/IAS.19.1.20636
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08


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