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2.
J Int AIDS Soc ; 19(1): 20917, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27370169

RESUMO

INTRODUCTION: UNAIDS "90-90-90" strategy calls for 90% of HIV-infected individuals to be diagnosed by 2020, 90% of whom will be on anti-retroviral therapy (ART) and 90% of whom will achieve sustained virologic suppression. Reaching these targets by 2020 will reduce the HIV epidemic to a low-level endemic disease by 2030. However, moving the global response towards this universal test and treat model will pose huge challenges to public health systems in resource-limited settings, including global and local supply chain systems. These challenges are especially acute in Africa, which accounts for over 70% of the persons affected by HIV. DISCUSSION: From a supply chain perspective, each of the "90's" has possible complications and roadblocks towards realizing the promise envisioned by 90-90-90. For instance, ensuring that 90% of HIV-infected persons know their status will require a large increase in access to HIV tests compared with what is currently available. To ensure that there are enough anti-retrovirals available to treat the nearly 25 million people that will require them by 2020 represents a near doubling of the ARV supplied to treat the 13 million currently on treatment. Similarly, to monitor those on treatment means an unprecedented scale-up of viral load testing throughout Africa. CONCLUSIONS: Larger issues include whether the capacity exists at the local level to handle these commodities when they arrive in the most severely affected countries, including considerations of the human resources and costs needed to make this strategy effective. We believe that such "real world" analysis of proposed strategies and policies is essential to ensure their most effective implementation.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Recursos em Saúde , Pandemias/prevenção & controle , África/epidemiologia , Infecções por HIV/economia , Planejamento em Saúde , Humanos , Carga Viral
3.
J Int AIDS Soc ; 18(Suppl 6): 20250, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26639111

RESUMO

INTRODUCTION: Integration of HIV into child survival platforms is an evolving territory with multiple connotations. Most literature on integration of HIV into other health services focuses on adults; however promising practices for children are emerging. These include the Double Dividend (DD) framework, a new programming approach with dual goal of improving paediatric HIV care and child survival. In this commentary, the authors discuss why integrating HIV testing, treatment and care into child survival platforms is important, as well as its potential to advance progress towards global targets that call for, by 2020, 90% of children living with HIV to know their status, 90% of those diagnosed to be on treatment and 90% of those on treatment to be virally suppressed (90-90-90). DISCUSSION: Integration is critical in improving health outcomes and efficiency gains. In children, integration of HIV in programmes such as immunization and nutrition has been associated with an increased uptake of HIV infant testing. Integration is increasingly recognized as a case-finding strategy for children missed from prevention of mother-to-child transmission programmes and as a platform for diffusing emerging technologies such as point-of-care diagnostics. These support progress towards the 90-90-90 targets by providing a pathway for early identification of HIV-infected children with co-morbidities, prompt initiation of treatment and improved survival. There are various promising practices that have demonstrated HIV outcomes; however, few have documented the benefits of integration on child survival interventions. The DD framework is well positioned to address the bidirectional impacts for both programmes. CONCLUSIONS: Integration provides an important programmatic pathway for accelerated progress towards the 90-90-90 targets. Despite this encouraging information, there are still challenges to be addressed in order to maximize the benefits of integration.


Assuntos
Infecções por HIV/prevenção & controle , Criança , Serviços de Saúde da Criança , Prestação Integrada de Cuidados de Saúde , Humanos , Lactente , Análise de Sobrevida
4.
PLoS One ; 9(6): e100741, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24968298

RESUMO

BACKGROUND: Prevention of mother-to-child transmission of HIV (PMTCT) programs can greatly reduce the vertical transmission rate (VTR) of HIV, and Malawi is expanding PMTCT access by offering HIV-infected pregnant women life-long antiretroviral therapy (Option B+). There is currently no empirical data on the effectiveness of Malawian PMTCT programs. This study describes a surveillance approach to obtain population-based estimates of the VTR of infants <3 months of age in Malawi immediately after the adoption of Option B+. METHODS AND FINDINGS: A sample of caregivers and infants <3 months from 53 randomly chosen immunization clinics in 4 districts were enrolled. Infant dried blood spot (DBS) samples were tested for HIV exposure with an antibody test to determine maternal seropositivity. Positive samples were further tested using DNA PCR to determine infant infection status and VTR. Caregivers were surveyed about maternal receipt of PMTCT services. Of the 5,068 DBS samples, 764 were ELISA positive indicating 15.1% (14.1-16.1%) of mothers were HIV-infected and passed antibodies to their infant. Sixty-five of the ELISA-positive samples tested positive by DNA PCR, indicating a vertical transmission rate of 8.5% (6.6-10.7%). Survey data indicates 64.8% of HIV-infected mothers and 46.9% of HIV-exposed infants received some form of antiretroviral prophylaxis. Results do not include the entire breastfeeding period which extends to almost 2 years in Malawi. CONCLUSIONS: The observed VTR was lower than expected given earlier modeled estimates, suggesting that Malawi's PMTCT program has been successful at averting perinatal HIV transmission. Challenges to full implementation of PMTCT remain, particularly around low reported antiretroviral prophylaxis. This approach is a useful surveillance tool to assess changes in PMTCT effectiveness as Option B+ is scaled-up, and can be expanded to track programming effectiveness for young infants over time in Malawi and elsewhere.


Assuntos
Monitoramento Epidemiológico , Infecções por HIV/transmissão , Imunização , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mães , Avaliação de Resultados em Cuidados de Saúde , Complicações Infecciosas na Gravidez/virologia , Adolescente , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Lactente , Malaui/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Adulto Jovem
5.
AIDS ; 27 Suppl 2: S225-33, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24361632

RESUMO

In 2011, Joint United Nations Programme on HIV/AIDS announced a plan to eliminate new HIV infections among children by 2015. This increased focus on the elimination of maternal to child transmission (MTCT) is most welcome but is insufficient, as access to prevention of MTCT (PMTCT) programming is neither uniform nor universal. A new and more expansive agenda must be articulated to ensure that those infants and children who will never feel the impact of the current elimination agenda are reached and linked to appropriate care and treatment. This agenda must addresses challenges around both reducing vertical transmission through PMTCT and ensuring access to appropriate HIV testing, care, and treatment for all affected children who were never able to access PMTCT programming. Option B+, or universal test and treat for HIV-infected pregnant women is an excellent start, but it may be time to rethink our current approaches to delivering PMTCT services. New strategies will reduce vertical transmission to less than 1% for those mother-infant pairs who can access them allowing for the contemplation of not just PMTCT, but actual elimination of MTCT. But expanded thinking is needed to ensure elimination of pediatric HIV.


Assuntos
Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Serviços Preventivos de Saúde/história , Garantia da Qualidade dos Cuidados de Saúde/normas , Adulto , Fármacos Anti-HIV/administração & dosagem , Criança , Intervalo Livre de Doença , Feminino , Saúde Global , Infecções por HIV/diagnóstico , História do Século XX , História do Século XXI , Humanos , Transmissão Vertical de Doenças Infecciosas/história , Perda de Seguimento , Masculino , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Desenvolvimento de Programas , Garantia da Qualidade dos Cuidados de Saúde/métodos , Garantia da Qualidade dos Cuidados de Saúde/tendências , Nações Unidas , Organização Mundial da Saúde
6.
AIDS ; 27 Suppl 2: S235-45, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24361633

RESUMO

There are 3.4 million children infected with HIV worldwide, with up to 2.6 million eligible for treatment under current guidelines. However, roughly 70% of infected children are not receiving live-saving HIV care and treatment. Strengthening case finding through improved diagnosis strategies, and actively linking identified HIV-infected children to care and treatment is essential to ensuring that these children benefit from the care and treatment available to them. Without attention or advocacy, the majority of these children will remain undiagnosed and die from complications of HIV. In this article, we summarize the challenges of identifying HIV-infected infants and children, review currently available evidence and guidance, describe promising new strategies for case finding, and make recommendations for future research and interventions to improve identification of HIV-infected infants and children.


Assuntos
Serviços de Saúde da Criança/organização & administração , Infecções por HIV , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Serviço Social/métodos , Adolescente , Adulto , Criança , Serviços de Saúde da Criança/normas , Crianças Órfãs , Pré-Escolar , Diagnóstico Precoce , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Acessibilidade aos Serviços de Saúde , Humanos , Programas de Imunização , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento/métodos , Vigilância da População/métodos , Gravidez , Política Pública , Apoio Social , Populações Vulneráveis , Adulto Jovem
9.
AIDS ; 27 Suppl 2: S179-86, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24361627

RESUMO

If children are to be protected from HIV, the expansion of PMTCT programs must be complemented by increased provision of paediatric treatment. This is expensive, yet there are humanitarian, equity and children's rights arguments to justify the prioritization of treating HIV-infected children. In the context of limited budgets, inefficiencies cost lives, either through lower coverage or less effective services. With the goal of informing the design and expansion of efficient paediatric treatment programs able to utilize to greatest effect the available resources allocated to the treatment of HIV-infected children, this article reviews what is known about cost drivers in paediatric HIV interventions, and makes suggestions for improving efficiency in paediatric HIV programming. High-impact interventions known to deliver disproportional returns on investment are highlighted and targeted for immediate scale-up. Progress will carry a cost - increased funding, as well as additional data on intervention costs and outcomes, will be required if universal access of HIV-infected children to treatment is to be achieved and sustained.


Assuntos
Fármacos Anti-HIV/economia , Serviços de Saúde da Criança/economia , Países em Desenvolvimento/economia , Infecções por HIV/economia , Custos de Cuidados de Saúde , Recursos em Saúde/economia , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/economia , Antirretrovirais/uso terapêutico , Fortalecimento Institucional , Criança , Serviços de Saúde da Criança/organização & administração , Serviços de Saúde da Criança/normas , Serviços de Saúde da Criança/provisão & distribuição , Análise Custo-Benefício , Saúde Global , Infecções por HIV/tratamento farmacológico , Recursos em Saúde/provisão & distribuição , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde/economia , Humanos , Desenvolvimento de Programas
10.
AIDS ; 27 Suppl 2: S159-67, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24361625

RESUMO

OBJECTIVE: Although antiretroviral treatment (ART) has reduced the incidence of HIV-related opportunistic infections among children living with HIV, access to ART remains limited for children, especially in resource-limited settings. This paper reviews current knowledge on the contribution of opportunistic infections and common childhood illnesses to morbidity and mortality in children living with HIV, highlights interventions known to improve the health of children, and identifies research gaps for further exploration. DESIGN AND METHODS: Literature review of peer-reviewed articles and abstracts combined with expert opinion and operational experience. RESULTS: Morbidity and mortality due to opportunistic infections has decreased in both developed and resource-limited countries. However, the burden of HIV-related infections remains high, especially in sub-Saharan Africa, where the majority of HIV-infected children live. Limitations in diagnostic capacity in resource-limited settings have resulted in a relative paucity of data on opportunistic infections in children. Additionally, the reliance on clinical diagnosis means that opportunistic infections are often confused with common childhood illnesseswhich also contribute to excess morbidity and mortality in these children. Although several preventive interventions have been shown to decrease opportunistic infection-related mortality, implementation of many of these interventions remains inconsistent. CONCLUSIONS: In order to reduce opportunistic infection-related mortality, early ART must be expanded, training for front-line clinicians must be improved, and additional research is needed to improve screening and diagnostic algorithms.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/mortalidade , Doenças Transmissíveis/mortalidade , Infecções por HIV/mortalidade , Recursos em Saúde/provisão & distribuição , Acessibilidade aos Serviços de Saúde , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/prevenção & controle , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/uso terapêutico , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Doenças Transmissíveis/diagnóstico , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Humanos , Lactente , Recém-Nascido , Masculino , Determinantes Sociais da Saúde , Tempo para o Tratamento/normas , Tempo para o Tratamento/estatística & dados numéricos
11.
AIDS ; 27 Suppl 2: S187-95, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24361628

RESUMO

Each year over a million infants are born to HIV-infected mothers. With scale up of prevention of mother-to-child transmission (PMTCT) interventions, only 210 000 of the 1.3 million infants born to mothers with HIV/AIDS in 2012 became infected. Current programmatic efforts directed at infants born to HIV-infected mothers are primarily focused on decreasing their risk of infection, but an emphasis on maternal interventions has meant follow-up of exposed infants has been poor. Programs are struggling to retain this population in care until the end of exposure, typically at the cessation of breastfeeding, between 12 and 24 months of age. But HIV exposure is a life-long condition that continues to impact the health and well being of a child long after exposure has ended. A better understanding of the impact of HIV on exposed infants is needed and new programs and interventions must take into consideration the long-term health needs of this growing population. The introduction of lifelong treatment for all HIV-infected pregnant women is an opportunity to rethink how we provide services adapted for the long-term retention of mother-infant pairs.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Assistência de Longa Duração , Complicações Infecciosas na Gravidez/prevenção & controle , Serviços Preventivos de Saúde , Fármacos Anti-HIV/efeitos adversos , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/efeitos adversos , Pré-Escolar , Comportamento Alimentar , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Lactente , Recém-Nascido , Masculino , Serviços de Saúde Materna/métodos , Serviços de Saúde Materna/normas , Gravidez , Efeitos Tardios da Exposição Pré-Natal
12.
AIDS ; 27 Suppl 2: S207-13, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24361630

RESUMO

In 2012, there were an estimated 2 million children in need of antiretroviral therapy (ART) in the world, but ART is still reaching fewer than 3 in 10 children in need of treatment. [1, 7] As more HIV-infected children are identified early and universal treatment is initiated in children under 5 regardless of CD4, the success of pediatric HIV programs will depend on our ability to link children into care and treatment programs, and retain them in those services over time. In this review, we summarize key individual, institutional, and systems barriers to diagnosing children with HIV, linking them to care and treatment, and reducing loss to follow-up (LTFU). We also explore how linkage and retention can be optimally measured so as to maximize the impact of available pediatric HIV care and treatment services.


Assuntos
Antirretrovirais/uso terapêutico , Prestação Integrada de Cuidados de Saúde/organização & administração , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Assistência de Longa Duração/normas , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Pré-Escolar , Promoção da Saúde/métodos , Disparidades em Assistência à Saúde/normas , Humanos , Lactente , Recém-Nascido , Perda de Seguimento , Cooperação do Paciente , Organização Mundial da Saúde
13.
AIDS ; 27 Suppl 2: S215-24, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24361631

RESUMO

Treatment 2.0 is an initiative launched by UNAIDS and WHO in 2011 to catalyze the next phase of treatment scale-up for HIV. The initiative defines strategic activities in 5 key areas, drugs, diagnostics, commodity costs, service delivery and community engagement in an effort to simplify treatment, expand access and maximize program efficiency. For adults, many of these activities have already been turned into treatment policies. The recent WHO recommendation to use a universal first line regimen regardless of gender, pregnancy and TB status is a treatment simplification very much in line with Treatment 2.0. But despite that fact that Treatment 2.0 encompasses all people living with HIV, we have not seen the same evolution in policy development for children. In this paper we discuss how Treatment 2.0 principles can be adapted for the pediatric population. There are several intrinsic challenges. The need for distinct treatment regimens in children of different ages makes it hard to define a one size fits all approach. In addition, the fact that many providers are reluctant to treat children without the advice of specialists can hamper decentralization of service delivery. But at the same time, there are opportunities that can be availed now and in the future to scale up pediatric treatment along the lines of Treatment 2.0. We examine each of the five pillars of Treatment 2.0 from a pediatric perspective and present eight specific action points that would result in simplification of pediatric treatment and scale up of HIV services for children.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Assistência Integral à Saúde , Infecções por HIV , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Pediatria/normas , Adulto , Fármacos Anti-HIV/economia , Criança , Análise Custo-Benefício , Prestação Integrada de Cuidados de Saúde , Indústria Farmacêutica/economia , Feminino , Saúde Global , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/economia , Infecções por HIV/transmissão , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Pediatria/educação , Gravidez , Desenvolvimento de Programas , Organização Mundial da Saúde
16.
Afr J Reprod Health ; 17(4 Spec No): 83-9, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24689319

RESUMO

Estimating the size of populations most affected by HIV such as men who have sex with men (MSM) though crucial for structuring responses to the epidemic presents significant challenges, especially in a developing society. Using capture-recapture methodology, the size of MSM-SW in Nigeria was estimated in three major cities (Lagos, Kano and Port Harcourt) between July and December 2009. Following interviews with key informants, locations and times when MSM-SW were available to male clients were mapped and designated as "hotspots". Counts were conducted on two consecutive weekends. Population estimates were computed using a standardized Lincoln formula. Fifty-six hotspots were identified in Kano, 38 in Lagos and 42 in Port Harcourt. On a given weekend night, Port Harcourt had the largest estimated population of MSM sex workers, 723 (95% CI: 594-892) followed by Lagos state with 620 (95%CI: 517-724) and Kano state with 353 (95%CI: 332-373). This study documents a large population of MSM-SW in 3 Nigerian cities where higher HIV prevalence among MSM compared to the general population has been documented. Research and programming are needed to better understand and address the health vulnerabilities that MSM-SW and their clients face.


Assuntos
Homossexualidade Masculina/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Coleta de Dados , Humanos , Masculino , Nigéria/epidemiologia , Sexo sem Proteção
17.
AIDS Care ; 24(4): 459-67, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22084826

RESUMO

The objective of this study was to determine extent of HIV conspiracy belief endorsement among men who have sex with men (MSM) in Pretoria, and assess whether endorsement of HIV conspiracy beliefs are associated with inconsistent condom use and never testing for HIV. A cross-sectional survey using respondent-driven sampling was conducted between February and August 2009. A high proportion of respondents endorsed HIV conspiracy beliefs. MSM commonly endorsed beliefs related to AIDS information being held back from the general public (51.0%), HIV being a man-made virus (25.5%), and people being used as guinea pigs in HIV research and with HIV treatments (approximately 20%). Bisexually- or heterosexually-identified MSM were significantly more likely to endorse conspiracy beliefs compared to homosexually-identified MSM (38.5% vs. 14.7%). Endorsing conspiracy beliefs was not associated with unprotected anal intercourse; however, it was significantly associated with not having been HIV tested (AOR: 2.4; 95% CI: 1.1-5.7). Endorsing beliefs in HIV conspiracies reflects a mistrust in government institutions and systems which could be an impediment to seeking HIV-related services, including HIV counseling and testing.


Assuntos
Cultura , Infecções por HIV , Mau Uso de Serviços de Saúde , Homossexualidade Masculina/psicologia , Adulto , Atitude Frente a Saúde , Bissexualidade/psicologia , Estudos Transversais , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Soropositividade para HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Mau Uso de Serviços de Saúde/prevenção & controle , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Assunção de Riscos , África do Sul/epidemiologia , Estereotipagem , Sexo sem Proteção/prevenção & controle , Sexo sem Proteção/psicologia
19.
Public Health Rep ; 125(2): 316-24, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20297760

RESUMO

While male-to-male sexual behavior has been recognized as a primary risk factor for human immunodeficiency virus (HIV), research targeting men who have sex with men (MSM) in less-developed countries has been limited due to high levels of stigma and discrimination. In response, the Population Council's Horizons Program began implementing research activities in Africa and South America beginning in 2001, with the objectives of gathering information on MSM sexual risk behaviors, evaluating HIV-prevention programs, and informing HIV policy makers. The results of this nearly decade-long program are presented in this article as a summary of the Horizons MSM studies in Africa (Senegal and Kenya) and Latin America (Brazil and Paraguay), and include research methodologies, study findings, and interventions evaluated. We also discuss future directions and approaches for HIV research among MSM in developing countries.


Assuntos
Países em Desenvolvimento , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Populações Vulneráveis , África/epidemiologia , Atitude do Pessoal de Saúde/etnologia , Atitude Frente a Saúde/etnologia , Países em Desenvolvimento/estatística & dados numéricos , Infecções por HIV/etnologia , Apoio ao Planejamento em Saúde , Política de Saúde , Homossexualidade Masculina/etnologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , América Latina/epidemiologia , Masculino , Seleção de Pacientes , Preconceito , Pesquisa Qualitativa , Projetos de Pesquisa , Assunção de Riscos , Estereotipagem , Sexo sem Proteção , Populações Vulneráveis/etnologia , Populações Vulneráveis/estatística & dados numéricos
20.
Public Health Rep ; 125(2): 305-15, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20297759

RESUMO

The Access-to-Treatment research initiative of the Population Council's Horizons program undertook 11 projects across Asia and sub-Saharan Africa from 2002 to 2008. The projects included a variety of cross-sectional exploratory studies, situation analyses, and longitudinal randomized, controlled intervention studies that examined service delivery, community awareness, health-seeking behaviors, adherence, cost, and other factors affecting treatment for adults and children infected with human immunodeficiency virus (HIV). This article summarizes the key findings and lessons learned from these projects, and examines cross-cutting issues such as stigma, quality of life, and sexual-risk behaviors among people living with HIV and acquired immunodeficiency syndrome on antiretroviral therapy. The article concludes with recommendations for evidence-based programming and future research around treatment for both children and adults.


Assuntos
Países em Desenvolvimento , Infecções por HIV/tratamento farmacológico , Acessibilidade aos Serviços de Saúde/organização & administração , Adulto , África Subsaariana/epidemiologia , Terapia Antirretroviral de Alta Atividade , Ásia , Criança , Confidencialidade , Estudos Transversais , Países em Desenvolvimento/estatística & dados numéricos , Infecções por HIV/etnologia , Educação em Saúde , Apoio ao Planejamento em Saúde , Humanos , Estudos Longitudinais , Aceitação pelo Paciente de Cuidados de Saúde , Desenvolvimento de Programas , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estereotipagem , Sexo sem Proteção
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