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Tytuł:
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Presenting a conceptual framework for an HIV prevention and care continuum and assessing the feasibility of empirical measurement in Estonia: A case study.
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Autorzy:
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Uusküla A; Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Vickerman P; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Raag M; Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Walker J; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Paraskevis D; Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Eritsyan K; National Research University Higher School of Economics, Saint-Petersburg, Russian Federation.
Sypsa V; Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Lioznov D; Smorodintsev Research Institute of Influenza, St. Petersburg, Russia.; First Pavlov State Medical University, St. Petersburg, Russia.
Avi R; Department of Microbiology, University of Tartu, Tartu, Estonia.
Des Jarlais D; College of Global Public Health, New York University, New York, NY, United States of America.
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Źródło:
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PloS one [PLoS One] 2020 Oct 09; Vol. 15 (10), pp. e0240224. Date of Electronic Publication: 2020 Oct 09 (Print Publication: 2020).
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Typ publikacji:
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Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: San Francisco, CA : Public Library of Science
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MeSH Terms:
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Continuity of Patient Care*
HIV Infections/*prevention & control
Adult ; Cross-Sectional Studies ; Empirical Research ; Estonia ; Feasibility Studies ; Female ; HIV Infections/etiology ; HIV Infections/therapy ; Humans ; Male ; Models, Biological ; Preventive Medicine/methods ; Substance Abuse, Intravenous/complications
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References:
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Lancet HIV. 2016 Jul;3(7):e318-22. (PMID: 27365206)
HIV Clin Trials. 2004 Mar-Apr;5(2):74-9. (PMID: 15116282)
AIDS. 2017 May 15;31(8):1181-1190. (PMID: 28323752)
AIDS Care. 2015;27(1):105-11. (PMID: 25054646)
AIDS Behav. 2018 Jan;22(1):224-233. (PMID: 28717981)
J Int AIDS Soc. 2019 Jul;22 Suppl 4:e25309. (PMID: 31328375)
Cochrane Database Syst Rev. 2011 Aug 10;(8):CD004145. (PMID: 21833948)
Clin Infect Dis. 2016 Oct 15;63(8):1094-1104. (PMID: 27343545)
AIDS. 2009 Jul 17;23(11):1397-404. (PMID: 19381076)
J Int AIDS Soc. 2016 Nov 17;19(1):21263. (PMID: 27863535)
BMJ. 2017 Dec 11;359:j5011. (PMID: 29229609)
Int J Epidemiol. 2014 Feb;43(1):235-48. (PMID: 24374889)
AIDS. 2013 Apr 24;27(7):1159-65. (PMID: 23902921)
Int J Drug Policy. 2014 Nov;25(6):1163-73. (PMID: 25449056)
Lancet HIV. 2016 Jul;3(7):e297-306. (PMID: 27365204)
BMJ. 2012 Oct 03;345:e5945. (PMID: 23038795)
HIV Med. 2012 Feb;13(2):89-97. (PMID: 21819529)
Clin Infect Dis. 2013 Oct;57(7):1014-20. (PMID: 23728143)
Medicine (Baltimore). 2016 Apr;95(15):e3361. (PMID: 27082595)
N Engl J Med. 2000 Mar 30;342(13):921-9. (PMID: 10738050)
Clin Infect Dis. 2015 Nov 15;61(10):1590-7. (PMID: 26270691)
Cochrane Database Syst Rev. 2017 Sep 18;9:CD012021. (PMID: 28922449)
Lancet HIV. 2018 Jun;5(6):e301-e308. (PMID: 29893243)
Clin Infect Dis. 2014 Jul;59 Suppl 1:S12-5. (PMID: 24926026)
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Grant Information:
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DP1 DA039542 United States DA NIDA NIH HHS
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Entry Date(s):
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Date Created: 20201009 Date Completed: 20201214 Latest Revision: 20211203
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Update Code:
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20240105
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PubMed Central ID:
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PMC7546465
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DOI:
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10.1371/journal.pone.0240224
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PMID:
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33035238
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Objective: We aim to show the feasibility of using an integrated prevention and care continuum (PCC) model as a complete and improved tool for HIV control measurement and programming. Alignment of prevention and care continua is essential to further improve health outcomes and minimize HIV transmission risk.
Design: Cross-sectional study.
Methods: Data from 977 persons who inject drugs (PWID) collected in 2011-2016 in Tallinn, Estonia, were used to construct an HIV PCC for PWID, stratified by risk for acquiring or transmitting HIV infection and by coverage of combined interventions. We also estimated the average protective effect of current levels of intervention provision.
Results: 74.4%, 20.3% and 35.2% of PWID were currently using needle and syringe programmes (NSP), drug treatment and HIV testing, respectively. 51.1% of current PWID were HIV seropositive and of those 62.5% were currently on ART and 19.0% were virally suppressed. Across the PCC, individuals moved between categories of being aware and ever using drug treatment (resulting in -50% "leakage"); from ever having used to currently using drug treatment (-59%); between "ever testing" and "current (continuous) testing" (-62%); and from self-reported antiretroviral therapy (ART) adherence to viral suppression (-70%). Use of prevention services was higher among those at risk of transmission (HIV positive). The overall reduction in acquisition risk among HIV-negative PWID was 77.7% (95% CrI 67.8-84.5%), estimated by the modelled protective effects of current levels of NSP, drug treatment and ART compared to none of these services.
Conclusions: Our findings suggest that developing a cohesive model for HIV prevention and treatment is feasible and reflects the bi-directional relationships between prevention and care. The integrated continuum model indicates the major factors which may predict the epidemic course and control response.
Competing Interests: The authors have declared that no competing interests exist.
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