Paediatric HIV and elimination of mother-to-child transmission of HIV in the ASEAN region: a call to action

Recent achievements in scaling up paediatric antiretroviral therapy (ART) have changed the life of children living with HIV, who now stay healthy and live longer lives. However, as it becomes more of a chronic infection, a range of new problems have begun to arise. These include the disclosure of HIV serostatus to children, adherence to ART, long-term toxicities of antiretroviral drugs and their sexual and reproductive health, which are posing significant challenges to the existing health systems caring for children with HIV with limited resources, experiences and capacities. While intensified efforts and actions to improve care and treatment for these children are needed, it is crucial to accelerate the prevention of mother-to-child transmission (PMTCT) of HIV, which is the main cause of paediatric HIV in the ASEAN region so as to eliminate the fundamental cause of the problem. This report argues that given over 70% of women have access to at least one antenatal care visit in the region and acceptance of HIV testing after receiving counselling on PMTCT could be as high as 90%, there is an opportunity to strengthen PMTCT services and eventually eliminate new paediatric HIV infections in the ASEAN countries

Hepatitis C in key populations in Latin America and the Caribbean: systematic review and meta-analysis

OBJECTIVES: Summarize hepatitis C virus (HCV) prevalence in injecting (IDU) and non-injecting drug users (NIDU), men who have sex with men (MSM), sex workers, and prison inmates in Latin America and the Caribbean (LAC). METHODS: Systematic review on HCV prevalence in sub-populations in LAC. Databases searched from 1-1-2000 to 10-30-2013. Inclusion criteria: prevalence studies in sub-populations in LAC. HCV-antibody was marker for prevalence of current/past HCV infection and HCV-RNA for prevalence of HCV current infection. RESULTS: IDU HCV current/past infection presented highest prevalence, from 1.7 % in Colombia to over 95 % in Ciudad Juarez and Tijuana, Mexico and pooled regional anti-HCV prevalence was 49 % (CI 95 % 22.6–76.3 %). NIDU, MSM and sex workers anti-HCV prevalence was below 10 %, and pooled regional prevalence of 4 % (CI 95 % 2.6–4.5 %), 3 % (CI 95 % 1.7–4.5 %) and 2 % (CI 95 % 1.0–3.4 %), respectively. Prison inmates presented higher values, but prevalence decreased over the 15-year time span (p < 0.001). Current HCV infection from three countries showed prevalence under 10 % in prison inmates and 1–46 % among drug users. CONCLUSIONS: Disease burden is high and surveillance, prevention and treatment should target these groups in LAC. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00038-015-0708-5) contains supplementary material, which is available to authorized users

Determinantes sociales y meta de tuberculosis en los Objetivos de Desarrollo Sostenible en las Américas

Objetivo. Determinar el comportamiento de los indicadores de incidencia de tuberculosis (TB) y número de muertes por TB en el marco de la meta 3.3 de los Objetivos de Desarrollo Sostenible (ODS) y su correlación con los determinantes sociales. Métodos. Se utilizó una metodología de estudio ecológico, en el cual la unidad de análisis es la población. Para el análisis de los determinantes sociales, se hizo uso del modelo de regresión binomial negativo y la fuerza de asociación. Resultados. En las Américas se ha presentado una disminución promedio anual en la tasa de incidencia de TB de 0,3% entre 2009 y 2018; sin embargo, de 2015 a 2018 ha habido un aumento, pasando de 27,6 a 28,8 por 100 000 habitantes. Con respecto a los determinantes sociales, los grupos de países con índice de desarrollo humano (IDH) y producto interno bruto (PIB) más bajos tienen una incidencia de TB más alta. El riesgo de TB en el país con IDH más bajo es seis veces mayor que en el país con IDH más alto. Conclusiones. Al ritmo de la disminución actual de la tasa de incidencia y del número de muertes por TB, la Región de las Américas no alcanzará las metas propuestas en los ODS y en la Estrategia Fin de la TB. Se requiere una implementación y expansión rápidas de las intervenciones en prevención y control de TB para lograrlo. Esto implica, entre otras acciones, reducir las barreras de acceso al diagnóstico y tratamiento y fortalecer las iniciativas para abordar los determinantes sociales.</p

Additional file 1: of Progress and challenges in implementing HIV care and treatment policies in Latin America following the treatment 2.0 initiative

Questionnaire Spanish version. (XLSX 61 kb

Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America

Submitted by Fábio Marques ([email protected]) on 2018-09-20T18:59:40Z No. of bitstreams: 1 Towards a fair consideration of PrEP as part of combination HIV prevention_Beatriz_Grinsztejn_etal_INI_Lapclin-AIDS_2016.pdf: 231546 bytes, checksum: a85fa3b286d4b42f0f852a5759955d26 (MD5)Approved for entry into archive by Regina Costa ([email protected]) on 2018-09-27T18:38:51Z (GMT) No. of bitstreams: 1 Towards a fair consideration of PrEP as part of combination HIV prevention_Beatriz_Grinsztejn_etal_INI_Lapclin-AIDS_2016.pdf: 231546 bytes, checksum: a85fa3b286d4b42f0f852a5759955d26 (MD5)Made available in DSpace on 2018-09-27T18:38:51Z (GMT). No. of bitstreams: 1 Towards a fair consideration of PrEP as part of combination HIV prevention_Beatriz_Grinsztejn_etal_INI_Lapclin-AIDS_2016.pdf: 231546 bytes, checksum: a85fa3b286d4b42f0f852a5759955d26 (MD5) Previous issue date: 2016Pan American Health Organization (PAHO), Washington, DC, USA.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Instituto Nacional de Salud Pública. Cuernavaca, México.Investigaciones Medicas en Salud. Lima, Peru.Ministerio de Salud y Protección Social. Bogotá, Colombia.Centro de Investigación Interdisciplinaria en Sexualidad, SIDA y Sociedad, Universidad Peruana Cayetano Heredia. Lima, Peru.Pan American Health Organization (PAHO). Washington, DC, USA.Despite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP) is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool. We discuss the barriers and solutions for a fair consideration of PrEP as part of combination HIV prevention strategies in Latin America