Health Policy Commons^™

Hiv Viral Load Suppression Before And After Covid-19 In Kinshasa And Haut Katanga, Democratic Republic Of The Congo, Gulzar H. Shah, Gina D. Etheredge, Stacy Smallwood, Lievain Maluantesa, Kristie C. Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky

Department of Health Policy and Community Health Faculty Publications

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.

Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.

Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.

Results: After controlling for covariates …

Socioeconomic Status And Other Factors Associated With Hiv Status Among Ovc In Democratic Republic Of Congo (Drc), Gulzar H. Shah, Gina D. Etheredge, Lievain Maluantesa, Kristie Cason Waterfield, Osaremhen Ikhile, Elodie Engetele, Astrid Mulenga, Alice Tabala, Bernard Bossiky

Department of Health Policy and Community Health Faculty Publications

Background: Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa.

Purpose: This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC.

Methods: For this quantitative retrospective study, we obtained data from ICAP/DRC for a total of 1,624 OVC from households enrolled for social, financial, and clinical services between January 2017 and April 2020 in two provinces of the Democratic Republic of Congo, Haut-Katanga and Kinshasa. We computed descriptive statistics for OVC and their parents' or guardians' characteristics. We …

Consequences Of Covid-19 Crisis For Persons With Hiv: The Impact Of Social Determinants Of Health, Kristie Cason Waterfield, Gulzar H. Shah, Gina D. Etheredge, Osaremhen Ikhile

Department of Health Policy and Community Health Faculty Publications

Background

With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases.

Discussion

As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher …

Capacity Of Rural Counties To Address An Hiv Or Hepatitis C Outbreak, Jennifer Lenardson Mhs, Jaclyn Janis Rn, Mph, Amanda Burgess Mppm, Karen Pearson Mlis, Ma, Martha Elbaum Mpa

Population Health

HIV and hepatitis C (HCV) are major public health concerns in the United States and are a focus of significant federal health policy attention. Rural counties may be potentially vulnerable to an HIV or HCV outbreak among persons who inject drugs due to greater prevalence of high-risk injection practices as well as limited public health capacity to prevent, prepare for, and respond to an HIV or HCV outbreak. This study identified states potentially at risk for an HIV or HCV outbreak and used data from the 2016 Association of State and Territorial Health Officials (ASTHO) Profile Survey, 2016 National Association …

Evaluating Racial And Ethnic Disparities In Access To Primary Care Among Gay And Bisexual Men In The Us, A Population At High-Risk Of Hiv Infection, Jessica S. Kiernan, April D. Kimmel

Graduate Research Posters

BACKGROUND: 69% of new HIV diagnoses in the US are among gay and bisexual men, with disparities by race and ethnicity. Primary care providers increasingly provide HIV prevention. Racial and ethnic disparities in primary care access are well-documented, but their persistence among gay and bisexual men is unknown. We examined racial and ethnic disparities in access to primary care among this population.

METHODS: We used nationally representative person-level sociodemographic, health status and utilization data, and data on organizational- and socially determinant barriers to care, from the National Health Interview Survey, 2013-2018. Outcomes were: 1) general physician visit

RESULTS: The sample …

U.S. Women And Hiv Infection, P. Clay Stephens

New England Journal of Public Policy

Women are inadequately provided with HIV services and education and are differentially denied access to these. Divisions of race, ethnicity, economic class, and religion, among others, are compounded by sexual discrimination within each of these categories.

Review of current data on women with AIDS reveals that the reporting methods used convey a false impression that women are not at significant risk. Moreover, the persons indirectly affected by AIDS are predominantly women — mothers, sisters, partners, family members, teachers, and human service workers. Thus, AIDS is more of a women's issue than the statistics imply.

Women, as a gender-defined class, face …

Human Immunodeficiency Virus In Intravenous Drug Users: Epidemiology, Issues, And Controversies, Donald E. Craven

New England Journal of Public Policy

Intravenous drug users are the second most common risk group for acquired immunodeficiency syndrome (AIDS) in the United States, and they account for approximately 25 percent of the cases. Drug users may spread human immunodeficiency virus (HIV) by sharing contaminated drug injection paraphernalia and through sexual contact; women who use drugs can transmit the virus to their children. The rapid spread of HIV in this risk group and the fact that intravenous drug users are a source for heterosexual and perinatal transmission underscore the need for immediate intervention. In addition, many drug addicts are poor, have limited career possibilities, and …