Implementation of the Treat All Policy Among Persons with HIV Infection Enrolled in Care But Not on Antiretroviral Therapy - India, May 2017-June 2018.
MMWR Morb Mortal Wkly Rep
; 67(47): 1305-1309, 2018 Nov 30.
Article
en En
| MEDLINE
| ID: mdl-31199351
ABSTRACT
Since September 2015, the World Health Organization has recommended antiretroviral therapy (ART) for all persons with human immunodeficiency virus (HIV) infection, regardless of clinical stage or CD4 count (1). This Treat All policy was based on evidence that ART initiation early in HIV infection as opposed to waiting for the CD4 count to decline to certain levels (e.g., <500 cells/mm3, per previous guidelines), was associated with reduced morbidity, mortality, and HIV transmission (2-4). Further, approximately half of persons enrolled in non-ART care that included monitoring for HIV disease progression (i.e., in pre-ART care) were lost to follow-up before becoming ART-eligible (5). India, the country with the third largest number of persons with HIV infection in the world (2.1 million), adopted the Treat All policy on April 28, 2017. This report describes implementation of Treat All during May 2017-June 2018, by India's National AIDS Control Organization (NACO) and partners, by facilitating ART initiation among persons previously in pre-ART care at 46 ART centers supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR)* in six districts in the states of Maharashtra and Andhra Pradesh. Partners supported these 46 ART centers in identifying and attempting to contact persons who were enrolled in pre-ART care during January 2014-April 2017, and educating those reached about Treat All. ART center-based records were used to monitor implementation indicators, including ART initiation. A total of 9,898 (39.6%) of 25,007 persons previously enrolled in pre-ART care initiated ART; among these 9,898 persons, 6,315 (63.8%) initiated ART after being reached during May 2017-June 2018, including 1,635 (16.5%) who had been lost to follow-up before ART initiation. NACO scaled up efforts nationwide to build ART centers' capacity to implement Treat All. Active tracking and tracing of persons with HIV infection enrolled in care but not on ART, combined with education about the benefits of early HIV treatment, can facilitate ART initiation.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
10_ODS3_salud_sexual_reprodutiva
/
11_ODS3_cobertura_universal
/
2_ODS3
/
4_TD
Problema de salud:
10_sexually_transmitted_infections
/
11_delivery_arrangements
/
11_governance_arrangements
/
2_cobertura_universal
/
2_enfermedades_transmissibles
/
4_aids
Asunto principal:
Infecciones por VIH
/
Fármacos Anti-VIH
/
Atención a la Salud
/
Política de Salud
Tipo de estudio:
Guideline
Aspecto:
Determinantes_sociais_saude
/
Implementation_research
Límite:
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
MMWR Morb Mortal Wkly Rep
Año:
2018
Tipo del documento:
Article