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Heterogeneities of the impact of public health policies on HIV/AIDS indicators in Brazil according to sociodemographic factors: A real‐life study.
- Source :
-
HIV Medicine . Feb2024, Vol. 25 Issue 2, p188-200. 13p. - Publication Year :
- 2024
-
Abstract
- Introduction: The impact of specific policies on HIV care has been scarcely investigated. In this study we aimed to analyze the impact of the Treatment For All policy (TFA‐2013) and the adoption of integrase strand transfer inhibitors (INSTIs‐2017) as first‐line therapy on clinical indicators of people living with HIV (PLHIV) in Brazil. Methods: We assessed the public database of Brazil's Ministry of Health and extracted data from 2009 to 2019. We investigated the impact of TFA and INSTIs with a time‐series analysis of four health indicators in PLHIV: antiretroviral treatment (ART) initiation with a CD4+ count >500/mm3; ART initiation <1 month after the first CD4+ measurement; viral load suppression (VLS); and treatment adherence. We explored trends over time by gender, age, macroregion of residency and municipal‐level social vulnerability index. Results: We included 753 316 PLHIV in 2019. Most were males (64.81%) in the 30–49 years age category (50.86%). We observed an overall improvement in all HIV clinical indicators, with notable impact of TFA on timely ART initiation and VLS, and mild impact of INSTIs on treatment adherence. Such improvements were heterogeneous, with remarkable gaps in gender, age and socioeconomic groups that have persisted over time. Indicators point to inferior outcomes among children, older adults, women and people living in socially vulnerable locations. Conclusions: Recent Brazilian public policies have had positive impacts on key HIV clinical indicators. However, our results highlight the need for specific policies to improve HIV care for children, older adults, women and socially vulnerable groups. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HEALTH policy
*HIV infections
*HIV-positive persons
*HIV integrase inhibitors
*KEY performance indicators (Management)
*VIRAL load
*AGE distribution
*PSYCHOLOGICAL vulnerability
*PUBLIC health
*SEX distribution
*CLINICAL medicine
*TIME series analysis
*CD4 lymphocyte count
*DRUGS
*DESCRIPTIVE statistics
*RESEARCH funding
*SOCIODEMOGRAPHIC factors
*HEALTH impact assessment
*PATIENT compliance
*RESIDENTIAL patterns
*DATA analysis software
*AIDS
Subjects
Details
- Language :
- English
- ISSN :
- 14642662
- Volume :
- 25
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- HIV Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 175229403
- Full Text :
- https://doi.org/10.1111/hiv.13553