Websites and Brand Strength: Achieving a 90% Positive Rating
Image result for the end of hiv...ACHIEVING THE 90–90–90 TARGETS, 2016 FIGURE 3.2. COUNTRIES...
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Transcript of Image result for the end of hiv...ACHIEVING THE 90–90–90 TARGETS, 2016 FIGURE 3.2. COUNTRIES...
HIV care cascade – WHO target
90-90-90: An ambitious treatment target to help end the AIDS epidemic. UNAIDS / JC2684 (English original, October 2014); WHO consolidated guidelines on HIV testing services. July 2015.
The treatment target
Diagnosed On treatment Virallysuppressed
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ACHIEVING THE 90–90–90 TARGETS,2016
FIGURE 3.2. COUNTRIES THAT HAVE ACHIEVED THE 90–90–90 TARGETS OR ARE NEAR TO
ACHIEVING THEM, MOST RECENT COUNTRY DATA1,2
Source: UNAIDS special analysis, 2017; see annex on methods for more details .
1 Data are for 2016, except as follows: 2015: Bulgaria, Germany, Hungary, Netherlands, Sweden, Switzerland, United Kingdom. 2014: Belgium, Canada, Serbia, Spain. 2013: Austria,
France. 2012: Italy. 2 Estimates of people living with HIV are supplied by the country and not validated by UNAIDS: Austria, Belgium, Bulgaria, Canada, Denmark, France, Germany,
Hungary, Iceland, Italy, Luxembourg, Malta, Netherlands, Portugal, Singapore, Spain, Switzerland, and the United Kingdom3 Estimates for citizens of the country only.
Figure 18: The London HIV treatment cascade among adults living with HIV, 2016
5Annual Epidemiological Spotlight on HIV in
London: 2016 data
94% 95%
100%
90%87% 85%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
People living with HIV People diagnosed withHIV
On treatment Virally suppressed
97%97%90%
AMSTERDAM
FIGURE 3.11. HIV TESTING AND TREATMENT CASCADE,
AMSTERDAM, 2015
Source: Stichting HIV Monitoring,
2017.
CITY CASESTUDY
BOTSWANA HAS ACHIEVED THE 90–90–90 TARGETS
FIGURE 3.10. KNOWLEDGE OF HIV STATUS, ANTIRETROVIRAL THERAPY
COVERAGE AND VIRAL SUPPRESSION AMONG PEOPLE LIVING WITH HIV,
BOTSWANA, 2016
Source: UNAIDS special analysis, 2017; see annex on methods for more details.
0
2
4
6
8
10
12
14
16
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 mid2015
690 0002.2 million
7.5 million
15.8 million16
Pe
op
le r
ece
ivin
g A
RT
(mill
ion
s)
14
12
10
8
6
4
2
0
Estimated numbers of people receiving antiretroviral therapy globally 2000–2015
Global AIDS Response Progress Reporting (UNAIDS/UNICEF/WHO). Available at: http://www.who.int/hiv/data/art_2003_2015.png?ua=1
Eastern Mediterranean region
South-East Asia regionAfrican region
European region
Region of the Americas
Western Pacific region
14.9 million
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HIV care cascade – WHO target
90-90-90: An ambitious treatment target to help end the AIDS epidemic. UNAIDS / JC2684 (English original, October 2014); WHO consolidated guidelines on HIV testing services. July 2015.
The treatment target
Diagnosed On treatment Virallysuppressed
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Global results: HIV treatment cascade
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……….………90%…………….………….………81%…………….…
……….………73%…………….…
57%(53-62%)
46%(43-50%)
38%(35-41%)
% of people living with HIV who know their HIV status
% of people living with HIV who are on ART
% of people living with HIV who are virally suppressed
Number of people newly infected with HIV
Source: UNAIDS/WHO estimates.
The red shading shows future targets.
Number of people dying from HIV
Source: UNAIDS/WHO estimates.
The red shading shows future targets.
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Hepatitis and HIV testing• Aim of study was to identify rates of HIV testing in patients with HBV
and/or HCV and to assess HIV testing practice in a large UK teaching hospital
• Retrospective case note review of 185 individuals with known hepatitis infection
Perera S, et al. HIV Med, 2011; 12 (Suppl. 1):87-91.
N 59288
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• During the year preceding the diagnosis, 46.6% of the patients had sought medical advice owing to the presence of clinical indicators that should have led to HIV testing.1
• Only 9% of patients eligible for screening were screened in a ED serving a population with a seroprevalence of 2%.2
• Sixty-one percent reported not undergoingHIV testing after their last STI diagnosis.3
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HIV disclosure and stigma
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Experiences in the dental setting compared to other clinical settings
http://www.stigmaindexuk.org
46%
40%
15%
5%
14%
9%
27%
13%
5%
14%14%
5%3% 2% 3%
Staff not awareof HIV status
Worried aboutbeing treated
differently
Reported beingtreated
differently
Felt refused ordelayed
treatment
Avoidedseeking care
Dental practice GP practice GUM clinic
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NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, non-nucleoside
reverse transcriptase inhibitor; PI, protease inhibitor; PK, pharmacokinetic
Antiretrovirals available in 2018
Adapted from http://www.aidsmeds.com/list.shtml
NRTIs
• Abacavir
• Didanosine
• Emtricitabine
• Lamivudine
• Stavudine
• Tenofovir
• Zidovudine
• TAF
PIs
• Atazanavir
• Darunavir
• Fosamprenavir
• Indinavir
• Lopinavir
• Nelfinavir
• Ritonavir
• Saquinavir
• Tipranavir
NNRTIs
• Delavirdine
• Efavirenz
• Etravirine
• Nevirapine
• Nevirapine XR
• Rilpivirine
Entry Inhibitors
• Maraviroc
Fusion Inhibitors
• Enfuvirtide
Integrase Inhibitors
• Raltegravir
• Dolutegravir
• Elvitegravir
• Bictegravir
PK Boosters
• Ritonavir
• Cobicistat
Single Pill Regimens
• Atripla
• Eviplera
• Stribild
• Triumeq
• Genvoya
• Odefsey
• Biktarvy
ASCEND: HCV Treatment Efficacy and Adherence by Provider Type
• Nonrandomized phase IV trial of HCV-infected pts in Washington, DC (N = 600)
• Pts mostly male (69%), black (96%), GT1a (72%), and treatment naive (82%)
– 20% of pts had compensated cirrhosis, 23% had HCV/HIV coinfection
• All providers received uniform 3-hr training
• No difference in SVR12 by provider type, cirrhosis status
• Adherence to all treatment visits by cirrhotic pts lower for specialists (61%) vs PCPs (56%) and NPs (75%) (P = .04)
Emmanuel B, et al. AASLD 2016. Abstract 22. Reproduced with permission.
ITT
SVR
12
(%
)
100
80
60
40
20
0NP Primary MD Specialist MD
89 86 83
Overall
86
135/151n/N =
138/160
240/289
513/600
