Can the United States achieve 90–90–90?
Purpose of review
To summarize recent trends in knowledge of HIV status, care and viral suppression, and the status of implementation of relevant contextual requirements for the United States to achieve the 90–90–90 goals. Recently, the US government announced a plan to decrease HIV incidence by over 90% by 2030. Reaching this goal may require higher targets than 90–90–90.
Recent findings
The United States is on course to reach 90–90–90 goals in the near future, with 86% of persons with HIV aware of their infection, 74% of persons with diagnosed infection in care, and 83% of persons in care with viral supp...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Is reaching 90–90–90 enough to end AIDS? Lessons from Amsterdam
Purpose of review
Although cities present opportunities for infectious pathogens such as HIV to spread, public health infrastructure within these cities also provides opportunities to design effective approaches to eliminate transmission of these pathogens. The HIV Transmission Elimination AMsterdam (H-TEAM) Initiative, a consortium of relevant stakeholders involved in HIV prevention and care, designed an integrated approach to curb the HIV epidemic in Amsterdam, including providing preexposure prophylaxis (PrEP), increasing awareness of acute HIV infection, offering same-day test and treat, and improving indicator disea...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Reaching 90–90–90 in rural communities in East Africa: lessons from the Sustainable East Africa Research in Community Health Trial
Purpose of review
There is an urgent need to understand new population-level approaches that achieve high levels of treatment and viral suppression for persons living with HIV.
Recent findings
The SEARCH Universal test and treat (UTT) trial conducted in Kenya and Uganda aimed to reduce HIV incidence and improve community health. SEARCH offered HIV and multidisease testing at health fairs followed by home testing for nonparticipants in 32 communities, each with approximately 10 000 persons. In the 16 intervention communities, UNAIDS 90–90–90 targets were achieved within 3 years, reaching ‘92–95–90’ and 79...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Reaching 90–90–90 in Botswana
Purpose of review
Botswana, a small country in southern Africa, has had a very high prevalence of HIV since about 1995. It seems important to analyze the response of this country to help us understand how it became one of the first nations to achieve the 90–90–90 targets.
Recent findings
Botswana began a national program for treatment of HIV/AIDS with ARVs in 2002. Initially established in the four largest population centers, it expanded to more than 30 sites throughout the country by 2004. Also in 2004, an ‘opt out’ system for HIV testing was introduced. The government-sponsored ARV regimen for initiation was...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Editorial: Can we end HIV as a public health problem globally? Progress towards achieving the UNAIDS 90–90–90 goals
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research
Editorial introduction
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTION Source Type: research
Universal health coverage and key populations
Purpose of review
There is renewed focus at global and national level to adopt commitments to ensure universal access to health services. The present study highlights key considerations to ensure that the commitment to ‘leave no one behind’ includes key populations, recognizing the specific impact of marginalization, stigma, discrimination, and criminalization on their access to health.
Recent findings
Universal health coverage (UHC) means that all people can use the promotive, preventive, curative, rehabilitative, and palliative health services they need, of sufficient quality to be effective, while also ensuring...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Comprehensive HIV risk reduction interventions for 2020 and beyond: product choices and effective service-delivery platforms for individual needs and population-level impact
Purpose of review
This review summarizes key HIV prevention strategies in the 2020 toolkit and discusses opportunities to maximize the public health impact of these prevention interventions at a population level.
Recent findings
HIV prevention has relied on counseling, HIV testing, and condom distribution for the past three decades. Recent exciting work has provided evidence on effective HIV prevention interventions, including antiretroviral therapy for HIV prevention, expanding preexposure prophylaxis modalities, and voluntary medical male circumcision which all reduce individual-level HIV risk. Efficient service-del...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Prisons: ignore them at our peril
Purpose of review
People with HIV and HCV are concentrated within criminal justice settings globally, primarily related to criminalization of drug use. This review examines updated prevention and treatment strategies for HIV and HCV within prison with a focus on people who inject drugs and the challenges associated with the provision of these services within prisons and other closed settings and transition to the community.
Recent findings
The prevalence of HIV and HCV are several-fold higher in the criminal justice system than within the broader community particularly in regions with high prevalence of injecting drug...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Transforming lives and empowering communities: evidence, harm reduction and a holistic approach to people who use drugs
We describe the current environment and review recent innovations and responses, including peer distribution of naloxone, low dead space syringes, drug consumption rooms and drug-checking services. However, despite efforts by people who use drugs and supporting partners to sustain harm reduction services and to develop and implement novel interventions, programmes are often under-scaled and under-resourced and people who use drugs continue to face significant barriers to accessing services.
Summary
There is an urgent need to bring existing harm reduction programmes to scale and to broaden their scope, as well to complem...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Strategies to promote the meaningful involvement of sex workers in HIV prevention and care
Purpose of review
We review the recent evidence regarding strategies for engaging sex workers in HIV prevention and care programs. We searched Pub Med on 19 March 2019 using terms ‘Sex Work’ And ‘HIV infections’. Our search was limited to articles published since 2017.
Recent findings
Community empowerment approaches where sex workers work collaboratively to address their specific priorities and concerns, including those beyond HIV, are those most likely to meaningfully engage sex workers. Community-driven programs that combine structural, behavioral and biomedical approaches can facilitate improved HIV outcom...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Strategies for engaging transgender populations in HIV prevention and care
Purpose of review
Transgender (trans) populations are heavily impacted by HIV, yet face structural, social, and individual barriers to engagement in HIV prevention and care. In this review, we summarize the data on barriers and facilitators and discuss evidence-informed strategies to facilitate access to and engagement in HIV prevention and care by trans communities.
Recent findings
Intersectional stigma and discrimination at structural, community, individual levels present substantial impediments to HIV prevention and optimal care. Access to gender-affirming health care is a priority for trans communities. Where tran...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Strategies to improve access for MSM in low-income and middle-income countries
Purpose of review
HIV prevention and treatment interventions for MSM are not well studied or reported from low-income and middle-income countries (LMIC) in comparison to those targeting gender-conforming populations. Some evidence-based strategies to engage MSM in appropriate healthcare have recently reported on their experiences and impact. Novel recruitment strategies have been developed for treatment and preexposure prophylaxis (PrEP) for MSM, leveraging new community engagement strategies and social media technologies.
Recent findings
Despite publication of several new guidelines, there is little recent evidence a...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Getting to grips with the HIV epidemic in Russia
Purpose of review
In contrast to global patterns, the HIV epidemic in the Russian Federation continues to expand. The epidemic remains largely concentrated among key populations and their sexual partners but has the potential of affecting the general population. We have focused our analysis on legislative, policy-related, structural, and cultural obstacles that the country faces in confronting its epidemic.
Recent findings
The Russian Federation has the largest HIV epidemic in Europe. Recent epidemiological analyses have shown a decrease in the annual growth of new reported infections. However, stigma and discriminati...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
Optimizing HIV prevention and treatment outcomes for persons with substance use in Central Asia: what will it take?
Purpose of review
To summarize the status of HIV and substance use in Central Asia and discuss potential ways to move forward to effective epidemic control among people who inject drugs (PWID) in the region and beyond.
Recent findings
PWID and their partners remain the population most affected by HIV in Central Asia. Lack of effective substance use prevention and treatment options and limited involvement of PWID-led community-based organizations in HIV programs, combined with the requirement for official registration, stigma and discrimination of PWID, and criminalization of drug use remain key barriers to effective H...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research
