Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

Identifying and Plugging the Leaks: Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

CTAC (Canadian Treatment Action Council), 2018

This project explored what issues impact engagement by people living with HIV with healthcare in Ontario. The goal was to identify policy issues that impact treatment access for people living with HIV, and to identify opportunities to make the healthcare system more accessible.

The HIV Cascade of Care is a useful description of the different steps that a person living with HIV will need to take in order to achieve an undetectable viral load and optimal health outcomes, from infection and diagnosis through to Antiretroviral Therapy (ART) initiation and viral suppression.

We know people drop out of the HIV Cascade of Care – e.g. why those starting treatment don’t stay on it. By seeking out policy barriers and developing solutions we can enable people to live long, healthy, and happy lives.

The project has five recommendations around barriers to engagement in the HIV Cascade of Care.

Download report here

 

HIV diagnoses hit seven year low: Australia’s annual HIV figures released

Kirby Institute, UNSW, Monday, 24 September 2018

Australia has recorded its lowest level of HIV diagnoses in seven years, according to a new report from the Kirby Institute at UNSW Sydney.

The report, released at the Australasian HIV&AIDS Conference in Sydney, found that there were 963 new HIV diagnoses in 2017, the lowest number since 2010.

Researchers are attributing the promising results to more people getting tested for HIV, more people living with HIV starting treatment which reduces the risk of HIV transmission to effectively zero, and an increased use of pre-exposure prophylaxis (or PrEP, an HIV prevention pill).

However, it is not all good news. According to the report, a quarter of new HIV diagnoses in 2017 were among heterosexuals, with a 10% increase in diagnoses over the past five years.

Among Aboriginal and Torres Strait Islander populations, HIV diagnoses have been increasing over the past five years, with rates almost two times higher than the Australian-born non-Indigenous population in 2017.

HIV rapid testing in community and outreach sites: results of a demonstration project in Italy

BMC Public Health

2018 18:748

Published: 18 June 2018mob

Abstract

Background

Globally the access to HIV testing has greatly increased over the past 30 years. Nonetheless, a high proportion of people living with HIV remains undiagnosed, even in resource rich countries. To increase the proportion of people aware of their HIV serostatus and their access to medical care, several strategies have been proposed including HIV rapid test programs offered outside health facilities. The aim of this project was to evaluate the feasibility and efficacy of the HIV rapid testing offered in community and outreach settings in Italy.

Methods

We conducted a national demonstration project on HIV rapid tests offered in community and outreach settings, including nongovernmental organization (NGO) facilities, primary care services for migrants and low-threshold services or mobile units for drug users (DU services). HIV rapid test on oral fluid (OraQuick®; Orasure Technologies) was anonymously offered to eligible people who presented themselves at the selected sites. Those with reactive results were referred to a specialized outpatient unit for confirmatory testing and medical care.

Results

Over a period of six months a total of 2949 tests were performed and 45.2% of individuals tested had not been previously tested. Overall 0.9% (27/2949) of tested people had a preliminary positive test. In NGO facilities the positivity rate was 1%. All subjects who performed their confirmatory test were confirmed as positive. In services for migrants the positivity rate was 0.5 and 80% were referred to care (with 1 false positive test). In DU services we observed the highest positivity rate (1.4%) but the lowest linkage to care (67%), with 1 false positive test.

Conclusion

Our project showed that the offering of an HIV rapid testing program in community and outreach settings in Italy is feasible and that it may reach people who have never been tested before, while having a significant yield in terms of new HIV diagnoses as well.

New evidence supports HIV screening in young adulthood

Science Daily, December 19, 2017

A new study suggests that the most beneficial age for a one-time screening HIV test of the general population would be age 25.

The report — led by researchers at Massachusetts General Hospital  working with the U.S. Centers for Disease Control and Prevention (CDC) and the Massachusetts Department of Public Health — will be published in the Journal of Adolescent Health and has been issued online.

HIV and hepatitis pre and post test discussion in Victoria: consultation report

Australian Research Centre in Sex, Health and Society, La Trobe University, Nov 2017

In February 2017, the Australian Research Centre in Sex, Health and Society (ARCSHS) at La Trobe University initiated a consultation which aimed to describe best practice in HIV, hepatitis B and hepatitis C pre and post test discussion in the Victorian context.

Building on existing evidence, and guided by the National Testing Policies, the purpose of this consultation was to better understand the components of a quality testing encounter in the era of elimination, with particular emphasis on the non-medical needs of people around the time of testing and diagnosis.

The focus of this consultation was to identify best practice in pre and post test discussion for HIV, hepatitis B and hepatitis C. A range of health and community providers and researchers discussed the fundamentals of best practice at length, and provided a great many insights into the components of quality testing services.
Importantly, most participants acknowledged that while best practice is a valuable notion, it is not attainable in all health care settings. Best practice, therefore, needs to be flexible enough to be able to fit into any setting where HIV, hepatitis B or hepatitis C testing may occur.

 

People who use drugs require prioritisation not exclusion in efforts to eliminate Hepatitis C

6th International Symposium on Hepatitis Care in Substance Users,  6th Sept 2017

An international conference bringing together hepatitis C experts from around the world is today calling for strategies to prioritise people who use drugs, saying hepatitis C elimination is impossible without them.

“The number of people around the world dying from hepatitis C is increasing. We have the tools to reverse this trend, to eliminate this disease and save millions of lives. But it will not happen until people who use drugs become a focus of our efforts,” said Associate Professor Jason Grebely, President of the International Network of Hepatitis C in Substance Users (INHSU), the convenors of the conference.