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: Introduction: This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. Methods: This qualitative study involved 90‐minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health‐related quality of life perceptions and gaps in patient empowerment in HIV care during February–May 2022. The COM‐B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents’ experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. Results: A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20−49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long‐term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. Conclusions: There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing., INTRODUCTION As of 2022, about 39.0 million people were living with human immunodeficiency virus (HIV) globally, with an estimated 0.7% of people living with HIV (hereafter “PLHIV”) aged 15−49 years [...]

As the COVID‐19 pandemic continues to spread [1], hospitals have turned their focus to diagnosing COVID‐19 in patients who present with respiratory symptoms, and there is a risk of missing [...]

: Introduction: Civil society organizations (CSOs) play an essential role in the global HIV/AIDS response. Past studies have described the beneficial role of CSOs in meeting the United Nations Programme on HIV/AIDS (UNAIDS) 90‐90‐90 target, but have not explored how political conditions, which influence the ability of CSOs to organize, have an impact on the cascade. This study explores the relationship between measures of democracy and its association with diagnosis rates among people living with HIV (PLHIV). Methods: This study analyses 2016 data derived from the Economist Intelligence Unit's Democracy Index (EIUDI), UNAIDS country estimates for PLHIV and PLHIV who knew their status in 2016, World Bank's 2016 data on nominal gross domestic product (GDP) per capita and country population, HIV Justice Network's 2016 data on HIV criminalization, and country‐level estimates for PLHIV, PLHIV who know their status, and expenditure on HIV prevention from other independent sources. An estimated HIV prevalence variable was constructed by dividing the estimated PLHIV population with the total population of a country. Analyses were limited to countries with available data on PLHIV who know their status (n = 111). Results: Of the 111 countries in the analytic sample, the mean democracy index score was 5.93 (of the 10), median estimated HIV prevalence was 0.20% (IQR 0.10‐0.65), median GDP per capita (in thousands, US dollar) was 4.88 (IQR 2.11‐13.79), and mean PLHIV who know their status is 67.12%. Preliminary analysis on the five component measures of the EIUDI revealed multicollinearity, and thus the composite democracy index score was used as the measure for democracy. Multivariate linear regression analyses revealed that democracy index scores (β = 2.10, SE = 1.02, p = 0.04) and GDP per capita (in thousands; β = 0.34. SE = 0.11, p < 0.01) were positively associated with diagnosis rates among PLHIV, controlling for country‐level expenditure on HIV prevention, HIV criminalization laws and estimated HIV prevalence. Conclusions: Results indicate that higher levels of democracy were positively associated with rates of diagnosis among PLHIV. Further analyses following wider implementation of universal testing and treatment is warranted, as well as the need for further research on the mechanisms through which political cultures specifically influence rates of diagnosis among PLHIV., Introduction A total of approximately 36.9 million people were living with HIV (PLHIV) as of 2017, of whom 9.4 million were estimated to not have known that they were living [...]

: Introduction: Achieving UNAIDS 90‐90‐90 targets is a crucial step towards ending the AIDS epidemic. Many countries have published estimates of care cascades, although often with methodological limitations. We describe an approach that used the national HIV registry as a starting‐point to determine the HIV care cascade and resulting UNAIDS 90‐90‐90 estimates for Singapore in 2014. Methods: HIV is a legally notifiable disease in Singapore. The anonymized HIV registry data provided for a back‐calculation model from the European Centre for Disease Prevention and Control to obtain 2014 estimates for the total number of persons living with HIV (PLHIV), and the count in the registry for proportions diagnosed with HIV and linked to care. Using additional data collected for a simple random sample from the registry, outcomes in 2015 and 2016 were ascertained retrospectively to derive proportions for those retained in care, on antiretroviral therapy, and achieved viral suppression. Findings were extrapolated to derive national estimates and UN90‐90‐90 estimates. Bootstrapped samples from the model and sample were used to derive 95% confidence intervals. Results: An estimated 6900 (95% CI 6650, 7050) persons were living with HIV and AIDS in 2014. Of these, 4948 were diagnosed with HIV, and 4820 had been linked to care. The random sample of 500 persons was further analysed, and of these, 87.2% were retained in care, 84.6% on antiretroviral therapy, and 79.6% had suppressed viral loads. The proportions of HIV‐infected individuals on antiretroviral therapy and achieving viral suppression were 60.7% (95% CI 58.4, 63.6) and 57.1% (95% CI 55.0, 60.5) respectively. The corresponding UNAIDS 90‐90‐90 estimates were 71.7% (95% CI 70.0, 74.2) of all persons diagnosed; 84.6% (95% CI 81.6, 87.4) of diagnosed persons being on antiretroviral therapy, and 94.1% (95% CI 91.6, 96.2) of persons on therapy having achieved viral suppression. Conclusions: A national HIV registry, alongside back‐calculation and additional data from a sample, can be used to estimate attainment of UNAIDS 90‐90‐90 targets and identify system gaps. The registry had advantages of providing a well‐established, comprehensive capture of diagnosed persons and easily accessible data. The same approach can be used elsewhere if similar data are available., Introduction Combination antiretroviral therapy (ART) has greatly reduced HIV‐associated mortality, morbidity and transmissibility. However, new infections, diagnoses of AIDS and deaths attributable to HIV/AIDS remain high. In 2014, the Joint [...]

Human immunodeficiency virus (HIV) continues to be a major public health issue, and the effectiveness of HIV prevention, diagnosis, treatment, and care varies, particularly in the Asia‐Pacific region. The rapid initiation of antiretroviral therapy (ART) is important to control the HIV epidemic and to optimize the health of people living with HIV; many guidelines now recommend ART initiation within 7 days of HIV diagnosis, with same‐day initiation for people diagnosed with HIV who feel ready. Many countries in the Asia‐Pacific region have already implemented or are moving towards implementation of rapid or same‐day ART initiation. However, there are many obstacles and challenges to its implementation, which vary substantially across the region. This article summarizes the latest evidence on rapid and same‐day ART initiation and discusses lessons learned and barriers to implementation in Asian countries, particularly focusing on Taiwan, Thailand, Singapore, and the Republic of Korea. [ABSTRACT FROM AUTHOR]

Purpose: To explore the all-cause mortality in patients with acquired immune deficiency syndrome (AIDS) and Cytomegalovirus (CMV) retinitis.Methods: A retrospective cohort study of patients with CMV retinitis (CMVR) presented to a tertiary referral center in Singapore from January 1, 2004, through December 31, 2015.Results: A total of 144 patients were studied (87 survived, 11 lost to follow up, 46 died). Patients with bilateral CMVR and six-month follow up CD4 + T cell count < 50 cells/mm3 have shorter time to mortality, compared to patients with CD4 + T cell count > 50 cells/mm3 (p < .001) and unilateral disease (p = .043). Baseline CD4 + T cell count, size and zone of initial primary retinitis lesions, recurrences of retinitis, and timing of combined antiretroviral therapy (cART) are not significantly associated with mortality.Conclusion: Bilateral ocular involvement and lack of immune recovery in patients with AIDS and CMVR are associated with shorter survival time. [ABSTRACT FROM AUTHOR]

Objectives: Voluntary HIV testing rates are still low in several Asian countries including Singapore. HIV self-testing (HIVST) has the potential to increase testing, leading to earlier diagnosis and better prognosis. However, the views of at-risk individuals, especially heterosexual men (HSM), who are not coming forward for testing are still poorly understood. In this study, we examined the barriers and facilitators to and delivery preferences for HIVST in order to implement an effective intervention in Singapore.Methods: From May 2017 to June 2018, 48 in-depth interviews were conducted with HSM aged 21-66 years and at risk of HIV infection. Participants were purposively sampled based on ethnicity, age and testing behaviour. Recruitment was done mainly at brothels and entertainment establishments in Singapore. Participants gave their views on HIV testing, factors affecting HIVST use and their preferred HIVST service delivery model.Results: Most participants preferred HIVST over conventional testing for its convenience, privacy, anonymity and autonomy, but older men still preferred conventional testing. Low self-perceived risk, low awareness and self-efficacy for HIVST, and non-comprehensive test for other STIs were reported as barriers to HIVST. There were mixed opinions on kit preference. A blood-based kit was favoured for higher accuracy, while the oral-fluid-based kit was favoured for ease of use. Participants wanted a human touch for post-test counselling and linkage to care only if they self-tested positive. Traditional media, internet and social media, and venue-based outreach were potential advertising platforms mentioned.Conclusions: A locally acceptable and feasible HIVST intervention must address the barriers and facilitators of using HIVST in order to improve HIV testing rates among this at-risk population who might otherwise delay or fail to present for testing. [ABSTRACT FROM AUTHOR]