NDLI: Disparities and Trends in Viral Suppression During a Transition to a 'Test and Treat' Approach to the HIV Epidemic, San Francisco, 2008-2012.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Schwarcz, Sandra Hsu, Ling Chin Scheer, Susan
Spatial Coverage	San Francisco
Description	Author Affiliation: Schwarcz S ( *San Francisco Department of Public Health)
Abstract	BACKGROUND: In 2010, 2 years before national recommendations to provide antiretroviral therapy for HIV-infected persons regardless of CD4 count, the San Francisco Department of Public Health (SFDPH) implemented a 'test and treat' strategy that expanded HIV testing and offered antiretroviral therapy to persons at all publicly funded HIV clinics. We used the SFDPH registry of HIV-infected persons to measure trends in the time to viral suppression of persons suppressed. METHODS: The Kaplan-Meier product limit method was used to assess trends in time from HIV diagnosis to viral suppression (HIV RNA <200 copies/mL) among persons diagnosed from 2008 to 2012. The annual proportion of persons living with HIV who were virally suppressed was measured for the years 2008 to 2012. Independent predictors of viral suppression were determined using proportional hazards regression for newly diagnosed cases and Poisson regression for living cases. RESULTS: Of the 2349 persons newly diagnosed, the median time from diagnosis to suppression decreased from 13 months in 2008 to 5 months in 2012 (P < 0.0001). Among the 11,787 persons living with HIV, the annual proportion suppressed increased from 69% in 2008 to 78% in 2012. African Americans, persons who inject drugs, persons without private insurance, and persons with nadir CD4 counts above 350 cells per cubic millimeter, were less likely to be virally suppressed. DISCUSSION: We found a decrease in time and overall population-level increases in viral suppression under a test and treat strategy and highlight sociodemographic disparities that may hamper the full benefit of this approach.
File Format	HTM / HTML
ISSN	15254135
Issue Number	5
Volume Number	70
e-ISSN	10779450
Journal	JAIDS Journal of Acquired Immune Deficiency Syndromes
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2015-12-15
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline AIDS Anti-hiv Agents Administration & Dosage Therapeutic Use Hiv Infections Diagnosis Drug Therapy Adolescent Adult Cd4 Lymphocyte Count Female Epidemiology Humans Male Middle Aged Population Surveillance Risk Factors San Francisco Viral Load Young Adult Journal Article Research Support, U.s. Gov't, P.h.s.
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Pharmacology (medical)

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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Disparities and Trends in Viral Suppression During a Transition to a 'Test and Treat' Approach to the HIV Epidemic, San Francisco, 2008-2012.