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This document provides key considerations on when clinically stable children, adolescents and women who are pregnant or breastfeeding as well as members of key populations (people who inject drugs, sex workers, men who have sex with men, transgender people and people living in prisons and closed settings) can benefit from access to ART services for clinically stable clients, including less frequent clinic visits and multi-month refills for ART and other medications. The guidance provides the rationale and the approach to expand differentiated ART delivery to populations of people living with HIV who previously may not have been considered “eligible” for ART delivery models for clinically stable clients.
Keywords: HIV, ART, treatment, health care
According to the WHO, about 2.3 million people are co-infected with HIV and the hepatitis C virus (HCV). Moreover, there were an estimated 1.75 million new hepatitis C virus (HCV) infections worldwide in 2015. HCV usually presents only mild symptoms, if any, until it is at an advanced stage, thereby making it difficult to recognize the disease early.
The primary purpose of antiretroviral therapy is to keep people living with HIV in good health. In the large majority of people living with HIV, antiretroviral medication can be chosen that reduce the amount of HIV in the blood to levels that are undetectable by standard laboratory tests. It can take some months to reduce viral levels to undetectable levels and allow the immune system to begin to recover.
The advent of point-of-care (POC) Early Infant Diagnosis (EID) technologies is a breakthrough that creates the opportunity to increase coverage of EID testing. It will allow same-day test results and enable the initiation of earlier treatment, as well as address some of the key limitations of conventional EID networks – in particular long turnaround times for tests and high rates of loss to follow up.
The hepatitis C virus (HCV) has long since been a neglected disease, given long latency periods before any chronic illness manifests, and the low cure rate and numerous side effects of the pegylated interferon-ribavirin treatment (hereinafter PEGINF). However, of late, given the development of revolutionary drugs called direct-acting antivirals (DAAs) that can cure the disease in as little as 8 weeks, international interest, and with it, international financial investment, has peaked.
With the 2016 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, WHO updated and launched new policy recommendations on the clinical and service delivery aspects of HIV treatment and care, and raised the bar to treat all PLHIV (Treat All). WHO has worked with countries to ensure uptake and implementation of these recommendations in support of the to the 90-90-90 targets.
Drug use and supply have been a sensitive and high-priority issue for successive governments in China since at least the Opium Wars in the mid-19th century. China’s policy response to drug use relies on punishment and coercion as central components, including compulsory detoxification, detention in labour camps or so-called ‘rehabilitation’ facilities, and compulsory registration with law enforcement authorities resulting in surveillance and random interrogations.
Yet, in the late-1990s, in a policy move that appeared to emphasize healthcare instead of punishment for people who inject drugs, China began implementing the world’s largest scale-up provision of opioid substitution therapy (OST) and needle and syringe programmes (NSP) – two critical harm reduction measures for preventing HIV transmission. However, the overall approach towards people who use drugs remains punitive and stigmatising in China. As drug use continues to rise and expand across a greater range of drugs (especially synthetic drugs such as methamphetamine), as well as amongst younger age groups, China requires a comprehensive system of evidence-based and humane drug treatment and harm reduction services capable of advancing the health and quality of life of individuals and communities.
Keywords: China, HIV, PWID, NSPs and OST, drugs, health, law
The International Council of AIDS Service Organizations (ICASO) developed this brief to provide the HIV community with current information and analysis of new and updated clinical data on the effectiveness of antiretroviral therapy (ART) in preventing HIV transmission to sexual partners of people living with HIV. While the health benefits of treatment will always be the primary purpose of ART, it is vital that the secondary benefits to people living with HIV and their sexual partners be fully understood and communicated.
Keywords: HIV, ART, transmission, advocacy, prevention
Infographic on hepatitis produced by WHO Regional Office for the Western Pacific.
The 90-90-90 targets and the HIV testing and treatment cascade are two ways of looking at the same data. The targets were instrumental in galvanizing global action for HIV treatment access.
Keywords: HIV, PLHIV, targets, treatment, testing