Objectives: Integration of HIV care with general healthcare may improve patient engagement. We assessed patient outcomes in four clinics offering HIV care integrated into primary care clinics in Yangon, Myanmar.
Methods: We carried out a retrospective cohort analysis of 4551 patients who started antiretroviral therapy between 2009 and 2017. Mortality and disengagement from care were assessed using Cox regression.
Results: People living with HIV presented late with low CD4 counts [median (25 , 75 percentile) = 178 (65, 308) from 4216 patients] and advanced HIV (69% with stage 3 or 4). Survival was 0.95 at 1 year and 0.90 at 5 years. Males were at a higher risk of mortality than females [unadjusted hazard ratio (uHR) = 1.6 (95% CI: 1.3-2.0). Patients linked to HIV care via antenatal care or partner/parent notification were at reduced risk of mortality [uHR = 0.4 (95% CI: 0.1-1.0) and uHR = 0.5 (95% CI: 0.3-0.7)] relative to patients who presented for HIV testing. The cumulative incidence of disengagement was 0.06 at 1 year and 0.15 at 5 years. Young adults had a higher risk of disengagement than did children and older patients. Women linked to HIV care via antenatal care services were at increased risk of disengagement relative to patients who came for HIV testing (uHR = 2.4; 95% CI: 1.7-3.4). Mortality and disengagement remained steady over calendar time as the programme scaled up.
Conclusions: HIV care within a primary care model is effective to attain early linkage to care, with high survival. However, close attention should be given to disengagement from care, in particular for pregnant women.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/hiv.12886 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A blueprint for large language model-augmented telehealth for HIV mitigation in Indonesia: A scoping review of a novel therapeutic modality.
Health Informatics J
January 2025
Department of Computer Science and Information Technology, La Trobe University, Melbourne, VIC, Australia.
The HIV epidemic in Indonesia is one of the fastest growing in Southeast Asia and is characterised by a number of geographic and sociocultural challenges. Can large language models (LLMs) be integrated with telehealth (TH) to address cost and quality of care? A literature review was performed using the PRISMA-ScR (2018) guidelines between Jan 2017 and June 2024 using the PubMed, ArXiv and semantic scholar databases. Of the 694 records identified, 12 studies met the inclusion criteria.
View Article and Find Full Text PDF[Acceptability and screening outcomes for hepatitis B, C and human inmunodeficiency virus using rapid diagnostic tests in patients undergoing outpatient endoscopy].
Rev Gastroenterol Peru
January 2025
Departamento de Gastroenterología, Pontificia Universidad Católica de Chile, Santiago, Chile; Departamento de Gastroenterología, Hospital Sótero del Río, Santiago, Chile.
Introduction: Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections are a global public health concern. In 2019, there were 295.9 million people with chronic hepatitis B and 57.
View Article and Find Full Text PDFEvaluation of preventive medicine amongst people living with human immunodeficiency virus attending a hospital-based care setting.
Intern Med J
January 2025
Department of Infectious Diseases, Westmead Hospital, Sydney, New South Wales, Australia.
Background: With improved outcomes in human immunodeficiency virus (HIV) due to the use of anti-retroviral therapy, ensuring adequate preventative healthcare and management of HIV-related comorbidities is essential.
Aims: To evaluate adherence with recommended guidelines for comorbidity and immunisation status screening amongst people living with HIV within a hospital-based setting across two timepoints.
Methods: A single-centre retrospective case series was conducted at a hospital between 2011 and 2021.
Costs analysis of integrating group interpersonal therapy into HIV care services in Senegal.
Int J Ment Health Syst
January 2025
University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France.
Introduction: Group Interpersonal Therapy (IPT), an evidence-based treatment of depression recommended by the WHO mhGAP Intervention Guide, was implemented through a task-shifting approach in Senegal, as a treatment for depressed people living with HIV (PLWH). Since a description of the resources used and the implementation costs incurred is necessary to inform policymakers better, this study aimed to estimate the costs associated with its implementation.
Methods: Intervention costs were analyzed using an "ingredients-based costing approach" from the provider's perspective.
Background: Women involved in the criminal legal system have elevated rates of opioid use disorder, which is treatable, and HIV, which is preventable with pre-exposure prophylaxis (PrEP). There are significant social and structural barriers to integrated delivery of PrEP and medications for opioid use disorder (MOUD), limiting women's ability to access these life-saving interventions. In a two parallel-arm randomized controlled trial, we are assessing an innovative eHealth delivery model that integrates PrEP with MOUD and is tailored to meet the specific needs of women involved in the criminal legal system.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!