Dataset Information

Growing challenges for HIV programmes in Asia: clinic population trends, 2003-2013.

ABSTRACT: The scale-up of antiretroviral therapy (ART) has led to a substantial change in the clinical population of HIV-positive patients receiving care. We describe the temporal trends in the demographic and clinical characteristics of HIV-positive patients initiating ART in 2003-13 within an Asian regional cohort. All HIV-positive adult patients that initiated ART between 2003 and 2013 were included. We summarized ART regimen use, age, CD4 cell count, HIV viral load, and HIV-related laboratory monitoring rates during follow-up by calendar year. A total of 16 962 patients were included in the analysis. Patients in active follow-up increased from 695 patients at four sites in 2003 to 11,137 patients at eight sites in 2013. The proportion of patients receiving their second or third ART regimen increased over time (5% in 2003 to 29% in 2013) along with patients aged ?50 years (8% in 2003 to 18% in 2013). Concurrently, CD4 monitoring has remained stable in recent years, whereas HIV viral load monitoring, although varied among the sites, is increasing. There have been substantial changes in the clinical and demographic characteristics of HIV-positive patients receiving ART in Asia. HIV programmes will need to anticipate the clinical care needs for their aging populations, expanded viral load monitoring, and, the eventual increase in second and third ART regimens that will lead to higher costs and more complex drug procurement needs.

SUBMITTER: De La Mata NL

PROVIDER: S-EPMC5534184 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Growing challenges for HIV programmes in Asia: clinic population trends, 2003-2013.

De La Mata Nicole L NL Kumarasamy Nagalingeswaran N Ly Penh Sun PS Ng Oon Tek OT Nguyen Kinh Van KV Merati Tuti Parwati TP Lee Man Po MP Do Cuong Duy CD Choi Jun Yong JY Ross Jeremy L JL Law Matthew G MG

AIDS care 20170129 10

The scale-up of antiretroviral therapy (ART) has led to a substantial change in the clinical population of HIV-positive patients receiving care. We describe the temporal trends in the demographic and clinical characteristics of HIV-positive patients initiating ART in 2003-13 within an Asian regional cohort. All HIV-positive adult patients that initiated ART between 2003 and 2013 were included. We summarized ART regimen use, age, CD4 cell count, HIV viral load, and HIV-related laboratory monitori ...[more]

PMID: 28132544

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Project description:BACKGROUND:Perceiving a personal risk for HIV infection is considered important for engaging in HIV prevention behaviour and often targeted in HIV prevention interventions. However, there is limited evidence for assumed causal relationships between risk perception and prevention behaviour and the degree to which change in behaviour is attributable to change in risk perception is poorly understood. This study examines longitudinal relationships between changes in HIV risk perception and in condom use and the public health importance of changing risk perception. METHODS:Data on sexually active, HIV-negative adults (15-54?years) were taken from four surveys of a general-population open-cohort study in Manicaland, Zimbabwe (2003-2013). Increasing condom use between surveys was modelled in generalised estimating equations dependent on change in risk perception between surveys. Accounting for changes in other socio-demographic and behavioural factors, regression models examined the bi-directional relationship between risk perception and condom use, testing whether increasing risk perception is associated with increasing condom use and whether increasing condom use is associated with decreasing risk perception. Population attributable fractions (PAFs) were estimated. RESULTS:One thousand, nine hundred eighty-eight males and 3715 females participated in ?2 surveys, contributing 8426 surveys pairs. Increasing risk perception between two surveys was associated with higher odds of increasing condom use (males: adjusted odds ratio [aOR]?=?1.39, 95% confidence interval [CI]?=?0.85-2.28, PAF?=?3.39%; females: aOR?=?1.41 [1.06-1.88], PAF?=?6.59%), adjusting for changes in other socio-demographic and behavioural factors. Those who decreased risk perception were also more likely to increase condom use (males: aOR?=?1.76 [1.12-2.78]; females: aOR?=?1.23 [0.93-1.62]) compared to those without change in risk perception. CONCLUSIONS:Results on associations between changing risk perception and increasing condom use support hypothesised effects of risk perception on condom use and effects of condom use on risk perception (down-adjusting risk perception after adopting condom use). However, low proportions of change in condom use were attributable to changing risk perception, underlining the range of factors influencing HIV prevention behaviour and the need for comprehensive approaches to HIV prevention.

Dataset Information

Growing challenges for HIV programmes in Asia: clinic population trends, 2003-2013.

Publications

Growing challenges for HIV programmes in Asia: clinic population trends, 2003-2013.

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