To help reach the UNAIDS 95-95-95 targets by 2025, the public health community must ensure that people living with HIV have access to antiretroviral therapy (ART). Access to this lifesaving medication is one issue; staying on it is another, because continuing ART is not always possible due to a variety of circumstances. In a project FHI 360 recently concluded in Nigeria, we demonstrated how machine learning can complement the efforts of health care workers to help people stay on ART.
Tagged: ART
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Total Quality Leadership and Accountability: Reaching the last mile in HIV epidemic control
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At recent global health meetings that assessed progress made against the HIV epidemic, presentation after presentation confirmed that the world is inching closer to epidemic control. The excitement at these gatherings was palpable. It would be the first time in human history that such a public health milestone would be achieved without either a cure or a vaccine.
As technical experts attending these meetings, we were struck by the critical importance of logistical and operational interventions, alongside biomedical ones, to reach the last mile. Yet, unlike the private sector, public health systems in low- and middle-income countries often remain underfunded and understaffed. This environment can make project management very challenging.
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Can women living with HIV and taking antiretroviral therapy use hormonal contraceptive methods?
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Extraordinary gains have been made in the last decade toward increasing access to antiretroviral therapy (ART) for HIV. With an eye toward ending the AIDS epidemic by 2030, UNAIDS recently released bold targets related to HIV diagnosis and treatment. By the year 2020, their aim is to have 90 percent of all people living with HIV aware of their status, 90 percent of people diagnosed with HIV receiving sustained ART and 90 percent of people on ART achieving viral suppression. As we move closer to these laudable public health goals, we must also consider how expansion of ART may affect and be affected by other health issues, such as prevention of unintended pregnancy among women living with HIV.
An increasingly important issue is whether certain ART regimens are expected to have drug interactions when used with certain hormonal contraceptive methods. In theory, an interaction could affect the efficacy of either medication or cause side effects or toxicity. If contraceptive efficacy decreases, the chances of contraceptive failure, unintended pregnancy and the accompanying consequences increase. A decrease in ART efficacy could lead to treatment failure, viral resistance and greater likelihood of subsequent HIV transmission. Increases in side effects or toxicity can affect quality of life and medication adherence. Yet, despite the importance of this issue, relatively few studies (particularly those with clinical outcomes such as ovulation, pregnancy or treatment failure) have been conducted.