The effect of care interruptions on mortality in adults resuming antiretroviral therapy.

Objective: To estimate the relative rate of all-cause mortality amongst those on antiretroviral treatment (ART) with a history of interruptions compared with those with no previous interruptions in care.

Design: Retrospective cohort study.

Methods: We used data from four South African cohorts participating in the International epidemiology Databases to Evaluate AIDS Southern Africa collaboration.

Availability of substance use screening and treatment within HIV clinical sites across seven geographic regions within the IeDEA consortium.

Background: Overwhelming evidence highlights the negative impact of substance use on HIV care and treatment outcomes. Yet, the extent to which alcohol use disorder (AUD) and other substance use disorders (SUD) services have been integrated within HIV clinical settings is limited. We describe AUD/SUD screening and treatment availability in HIV clinical sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium.

Facility-Based Indicators to Manage and Scale Up Cervical Cancer Prevention and Care Services for Women Living With HIV in Sub-Saharan Africa: a Three-Round Online Delphi Consensus Method.

Background: Of women with cervical cancer (CC) and HIV, 85% live in sub-Saharan Africa, where 21% of all CC cases are attributable to HIV infection. We aimed to generate internationally acceptable facility-based indicators to monitor and guide scale up of CC prevention and care services offered on-site or off-site by HIV clinics.

Methods: We reviewed the literature and extracted relevant indicators, grouping them into domains along the CC control continuum.

Associations of inter-annual rainfall decreases with subsequent HIV outcomes for persons with HIV on antiretroviral therapy in Southern Africa: a collaborative analysis of cohort studies.

Background: Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa.

Methods: Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration.

Effect of the Friendship Bench Intervention on Antiretroviral Therapy Outcomes and Mental Health Symptoms in Rural Zimbabwe: A Cluster Randomized Trial.

Importance: Common mental disorders (CMD), which include depression and anxiety, are prevalent among people living with HIV and are associated with suboptimal antiretroviral therapy (ART) adherence.

Objective: To assess the effect of a lay health worker-led psychological intervention on ART adherence, virologic suppression, and mental health symptoms.

Design, Setting, And Participants: Open-label pragmatic cluster trial with 1:1 block randomization of 16 health facilities in rural Bikita, Zimbabwe.

Effect of the Friendship Bench intervention on antiretroviral therapy outcomes and mental health symptoms in rural Zimbabwe: A cluster randomized trial.

Importance: Common mental disorders (CMD) are prevalent in people living with HIV and associated with suboptimal antiretroviral therapy (ART) adherence.

Objective: To assess the effect of a lay health worker-led psychological intervention on adherence to ART, virologic suppression and mental health symptoms.

Design: Pragmatic cluster trial with block randomization of health facilities.

Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study.

We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector HIV programme to examine adherence and viral non-suppression (viral load > 400 copies/mL) of participants with (20,743, 38%) and without (33,635, 62%) mental health diagnoses. Mental health diagnoses were associated with unfavourable adherence patterns. The risk of viral non-suppression was higher among patients with organic mental disorders [adjusted risk ratio (aRR) 1.

Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study.

Objectives: To examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).

Setting: Sixteen government-funded health facilities in the rural Bikita district of Zimbabwe.

Design: Cross-sectional study.

Mental health, substance use and viral suppression in adolescents receiving ART at a paediatric HIV clinic in South Africa.

Introduction: Mental health problems are prevalent in adolescents living with HIV (ALHIV), often remain untreated, and may negatively affect antiretroviral therapy (ART) adherence and viral suppression. We implemented routine mental health screening at a paediatric ART clinic to improve the identification and management of mental health problems in ALHIV. In this report, we examine screening outcomes, associated patient characteristics and the odds of unsuppressed viral load in ALHIV screening positive for mental disorders.

International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012-2019.

Purpose: The objectives of the International epidemiology databases to evaluate AIDS (IeDEA) are to (i) evaluate the delivery of combination antiretroviral therapy (ART) in children, adolescents and adults in sub-Saharan Africa, (ii) to describe ART regimen effectiveness, durability and tolerability, (iii) to examine HIV-related comorbidities and coinfections and (iv) to examine the pregnancy-related and HIV-related outcomes of women on ART and their infants exposed to HIV or ART in utero or via breast milk.

Participants: IeDEA is organised in four regions (Central, East, Southern and West Africa), with 240 treatment and care sites, six data centres at African, European and US universities, and almost 1.4 million children, adolescents and adult people living with HIV (PLWHIV) enrolled.

Impact of Universal Antiretroviral Treatment Eligibility on Rapid Treatment Initiation Among Young Adolescents with Human Immunodeficiency Virus in Sub-Saharan Africa.

Background: Young adolescents with perinatally acquired human immunodeficiency virus (HIV) are at risk for poor care outcomes. We examined whether universal antiretroviral treatment (ART) eligibility policies (Treat All) improved rapid ART initiation after care enrollment among 10-14-year-olds in 7 sub-Saharan African countries.

Methods: Regression discontinuity analysis and data for 6912 patients aged 10-14-years were used to estimate changes in rapid ART initiation (within 30 days of care enrollment) after adoption of Treat All policies in 2 groups of countries: Uganda and Zambia (policy adopted in 2013) and Burundi, Democratic Republic of the Congo, Kenya, Malawi, and Rwanda (policy adopted in 2016).

Research priorities to inform "Treat All" policy implementation for people living with HIV in sub-Saharan Africa: a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA).

Introduction: "Treat All" - the treatment of all people with HIV, irrespective of disease stage or CD4 cell count - represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation.

Methods: The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA.

Using concept mapping to develop a human rights based indicator framework to assess country efforts to strengthen rehabilitation provision and policy: the Rehabilitation System Diagnosis and Dialogue framework (RESYST).

Background: Rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of "leaving no one behind" countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability.

Stakeholder Dialogue as Deliberation for Decision Making in Health Policy and Systems: The Approach from Argumentation Theory.

Objective: The literature on knowledge translation and dissemination in health care highlights the value of the stakeholder dialogue, namely, a structured process where stakeholders interact to identify the best solution to a given problem. By analyzing the stakeholder dialogue as a form of deliberative argumentation, this article identifies those factors that may hinder or facilitate reaching agreement among stakeholders on options to target problems.

Design: Conceptual analysis based on the descriptive and evaluation methods of argumentation theory.

Mortality and longevity after a spinal cord injury: systematic review and meta-analysis.

Background/aims: Mortality and longevity studies of spinal cord injury (SCI) are essential for informing healthcare systems and policies. This review evaluates the current evidence among people with SCIs worldwide in relation to the WHO region and country income level; demographic and lesion characteristics; and in comparison with the general population.

Methods: A systematic review of relevant databases for original studies.

Dissemination, analysis, and implementation of the World Report on Disability: the roadmap of the International Society for Physical and Rehabilitation Medicine.

The International Society for Physical and Rehabilitation Medicine has recognized the World Report on Disability as a guide for its future activities and endorsed its responsibility to disseminate, to analyze, and to implement the report's recommendations. The activities of the International Society for Physical and Rehabilitation Medicine on the global stage are embedded in a strategy that includes national and regional associations. This article reports on recent and forthcoming activities of the International Society for Physical and Rehabilitation Medicine regarding the World Report on Disability and identifies five major challenges that will impact future International Society for Physical and Rehabilitation Medicine activities.

The World Report on Disability: a challenge for rehabilitation medicine.

To analyze the life situation of people with disabilities and to summarize the evidence of measures to support their participation, the World Health Assembly requested the World Health Organization to produce a World Report on Disability. This article highlights some of the main contents of the World Report on Disability, with a special focus on the rehabilitation chapter. It starts by presenting epidemiologic findings on the global disability prevalence, views on the role of rehabilitation medicine, discrepancies between met and unmet needs, and challenges for the quality of rehabilitation services and ends with an outlook on the report's recommendations and efforts toward their implementation.

Analysis and implementation of a World Health Organization health report: methodological concepts and strategies.

A long-standing scientific discourse on the use of health research evidence to inform policy has come to produce multiple implementation theories, frameworks, models, and strategies. It is from this extensive body of research that the authors extract and present essential components of an implementation process in the health domain, gaining valuable guidance on how to successfully meet the challenges of implementation. Furthermore, this article describes how implementation content can be analyzed and reorganized, with a special focus on implementation at different policy, systems and services, and individual levels using existing frameworks and tools.

The World Report on Disability – implications, perspectives and opportunities for physical and rehabilitation medicine (PRM).

On June 9th 2011 the WHO World Report on Disability(WRD), called for by the World Health Assembly (WHA),was launched at the United Nations headquarters in NewYork. The WRD displays what has come to be known as the integrative model of functioning and disability as expressed in the International Classification of Functioning, Disability and Health (ICF). The present paper summarizes the representation of the role of rehabilitation in the WRD.

Chapter 6: The policy agenda of ISPRM.

This paper suggests a comprehensive policy agenda and first steps to be undertaken by the International Society of Physical and Rehabilitation Medicine (ISPRM) in order to realize its humanitarian, professional and scientific mandates. The general aims of ISPRM, as formulated in its guiding documents, the relations with the World Health Organization (WHO) and the United Nations system, and demands of ISPRM's constituency herein form the basis of this policy agenda. Agenda items encompass contributions to the establishment of rehabilitation services worldwide and the development of rapid rehabilitation disaster response, the enhancement of research capacity in Physical and Rehabilitation Medicine (PRM), and the development of PRM societies.

Chapter 5: Organizational structures suited to ISPRM's evolving role as an international non-governmental organization in official relation with the world health organization.

International non-governmental organizations (NGOs) in official relation with the World Health Organization (WHO) face organizational challenges against the background of legitimate representation of their membership and accountable procedures within the organization. Moreover, challenges arise in the light of such an international NGO's civil societal mandate to help reach the "health-for-all" goals as defined by WHO and to facilitate the implementation of the United Nations (UN) Convention on the Rights of Persons with Disabilities. The objective of this paper is to examine how such an international NGO using the International Society of Physical and Rehabilitation Medicine (ISPRM) as a case in point can address these challenges.

Chapter 4: A policy process and tools for international non-governmental organizations in the health sector using ISPRM as a case in point.

The politics of international non-governmental organizations (NGOs) such as the International Society of Physical and Rehabilitation Medicine (ISPRM) serve the function of selecting and attaining particular socially valued goals. The selection and attainment of goals as the primary function of political action can be structured along a policy process or cycle comprising the stages of strategic goal setting and planning of strategic pathways, agenda setting, resource mobilization, implementation, evaluation and innovation. At the various stages of this policy process different policy tools or instruments, which can be used to influence citizen and organizational behaviour in the light of defined goals, can be applied.

Chapter 3: International non-governmental organizations in the emerging world society: the example of ISPRM.

Using the International Society of Physical and Rehabilitation Medicine (ISPRM) as a case in point, the paper describes the complex world societal situation within which non-governmental organizations that address health issues have to operate.This paper describes the complex world societal situation within which non-governmental organizations (NGOs), that are addressing health issues have to operate. In particular, as an international organization in official relation with the World Health Organization (WHO), ISPRM is confronted with a variety of responsibilities and a true world health political mandate.

Chapter 2: ISPRM's way forward.

This paper outlines approaches to developing the International Society of Physical and Rehabilitation Medicine (ISPRM) and addresses many current challenges. Most importantly, these approaches provide the basis for ISPRM to develop its leadership role within the field of Physical and Rehabilitation Medicine (PRM) and in relation to the World Health Organization (WHO) and the United Nations (UN) system at large. They also address a number of specific critiques of the current situation.