Decreasing Adult Prevalence of Advanced HIV Disease From 2 Population-Based HIV Impact Assessments in Eswatini, Lesotho, Malawi, Tanzania, Uganda, Zambia, and Zimbabwe, 2015-2023.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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West Christine A, Mungai Elisabeth, Birhanu Sehin, Laws Rebecca, Agyemang Elfriede, Godfrey Catherine, Stafford Kristen, Mahlalela Khophozile, Li Michelle, Pasipamire Munyaradzi, Philip Neena M, Motebang Maletsatsi, Sachathep Karampreet K, Wilson Bilaal, Kalata Newton, Bateganya Moses, Mbunda Andrea, Sumba Samwel, Njau Prosper F, Kirungi Wilford, Gianetti Brittany, Biraro Samuel, Mugisha Veronicah, Sivile Suilanji, Mutukwa John, Mweebo Keith, Kancheya Nzali G, Auld Andrew, Mugurungi Owen, Peterson Amy, Malaba Rickie, Maphosa Talent, Suthar Amitabh B, Farley Shannon, Ussery Faith, Bronson Megan A, Brown Kristin H, Patel Hetal K, Justman Jessica E, Voetsch Andrew C
Аннотация
METHODS: We pooled data from 2 rounds of the Population-Based HIV Impact Assessment (PHIA) surveys from 7 countries among persons with HIV (PWH) aged 15 to 59 years. AHD was defined as having an HIV-positive result and CD4 <200 cells/mm3. Awareness of HIV diagnosis and treatment status were based on self-report and detection of antiretrovirals. Weighted estimates between survey rounds were compared through complex survey methods.
RESULTS: Across all countries, 13.2% and 6.8% of PWH met criteria for AHD during rounds 1 and 2, respectively. AHD prevalence among those aware of their HIV status and not on antiretroviral therapy (ART) increased by 31.7% (20.8% to 27.4%) but decreased by 17.7% (17.5% to 14.4%) among those unaware and not on ART and by 53.3% (10.5% to 4.9%) among those aware and on ART. The adjusted odds ratio for AHD comparing rounds 1 and 2 among those aware and on ART was 0.46 (95% CI, 0.39-0.53). Those who were aware and on ART accounted for the majority of PWH with AHD in both rounds (51.6%, round 1; 58.8%, round 2).
CONCLUSIONS: These findings indicate substantial reductions in AHD prevalence among those on ART between 2015-2017 and 2019-2023. Continued efforts are warranted to ensure timely diagnoses and treatment adherence and reduce barriers to care reengagement, which represent an increasingly important driver of AHD.