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  1. Article ; Online: Leveraging emergency care to reach key populations for 'the last mile' in HIV programming: a waiting opportunity.

    Smith-Sreen, Joshua / Bosire, Rose / Farquhar, Carey / Katz, David A / Kimani, Joshua / Masyuko, Sarah / Mello, Michael J / Aluisio, Adam R

    AIDS (London, England)

    2023  Volume 37, Issue 15, Page(s) 2421–2424

    MeSH term(s) Humans ; HIV Infections/prevention & control ; Emergency Medical Services
    Language English
    Publishing date 2023-11-16
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 639076-6
    ISSN 1473-5571 ; 0269-9370 ; 1350-2840
    ISSN (online) 1473-5571
    ISSN 0269-9370 ; 1350-2840
    DOI 10.1097/QAD.0000000000003709
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Implementation and Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) Program in Nairobi, Kenya: A Quasi-Experimental Prospective Study.

    Aluisio, Adam R / Smith-Sreen, Joshua / Offorjebe, Agatha / Maina, Wamutitu / Pirirei, Sankei / Kinuthia, John / Bukusi, David / Waweru, Harriet / Bosire, Rose / Ojuka, Daniel K / Eastment, McKenna C / Katz, David A / Mello, Michael J / Farquhar, Carey

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: Background: Persons seeking emergency injury care are often from underserved key populations (KPs) and priority populations (PPs) for HIV programming. While facility-based HIV Testing Services (HTS) in Kenya are effective, emergency department (ED) ... ...

    Abstract Background: Persons seeking emergency injury care are often from underserved key populations (KPs) and priority populations (PPs) for HIV programming. While facility-based HIV Testing Services (HTS) in Kenya are effective, emergency department (ED) delivery is limited, despite the potential to reach underserved persons.
    Methods: This quasi-experimental prospective study evaluated implementation of the HIV Enhanced Access Testing in Emergency Departments (HEATED) at Kenyatta National Hospital ED in Nairobi, Kenya. The HEATED program was designed using setting specific data and utilizes resource reorganization, services integration and HIV sensitization to promote ED-HTS. KPs included sex workers, gay men, men who have sex with men, transgender persons and persons who inject drugs. PPs included young persons (18-24 years), victims of interpersonal violence, persons with hazardous alcohol use and those never previously HIV tested. Data were obtained from systems-level records, enrolled injured patient participants and healthcare providers. Systems and patient-level data were collected during a pre-implementation period (6 March - 16 April 2023) and post-implementation (period 1, 1 May - 26 June 2023). Additional, systems-level data were collected during a second post-implementation (period 2, 27 June - 20 August 2023). Evaluation analyses were completed across reach, effectiveness, adoption, implementation and maintenance framework domains.
    Results: All 151 clinical staff were reached through trainings and sensitizations on the HEATED program. Systems-level ED-HTS increased from 16.7% pre-implementation to 23.0% post-implementation periods 1 and 2 (RR=1.31, 95% CI:1.21-1.43; p<0.001) with a 62.9% relative increase in HIV self-test kit provision. Among 605 patient participants, facilities-based HTS increased from 5.7% pre-implementation to 62.3% post-implementation period 1 (RR=11.2, 95%CI:6.9-18.1; p<0.001). There were 440 (72.7%) patient participants identified as KPs (5.6%) and/or PPs (65.3%). For enrolled KPs/PPs, HTS increased from 4.6% pre-implementation to 72.3% post-implementation period 1 (RR=13.8, 95%CI:5.5-28.7, p<0.001). Systems and participant level data demonstrated successful adoption and implementation of the HEATED program. Through 16-weeks post-implementation a significant increase in ED-HTS delivery was maintained as compared to pre-implementation.
    Conclusions: The HEATED program increased ED-HTS and augmented delivery to KPs/PPs, suggesting that broader implementation could improve HIV services for underserved persons, already in contact with health systems.
    Language English
    Publishing date 2024-04-04
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2024.04.03.24305277
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Commercial and Social Value of Pharmaceutical Industry-led Access Programs: Conceptual Framework and Descriptive Analysis.

    Smith-Sreen, Joshua / Heerdegen, Anne Christine S / Wirtz, Veronika J / Kulkarni, Priyanka / Machado, Melissa / Rockers, Peter C

    Health systems and reform

    2022  Volume 8, Issue 1, Page(s) e2057831

    Abstract: Pharmaceutical industry-led access programs are growing in number globally and are increasingly adopting a hybrid approach intended to generate commercial and social value in parallel. We developed and applied a new conceptual framework in a descriptive ... ...

    Abstract Pharmaceutical industry-led access programs are growing in number globally and are increasingly adopting a hybrid approach intended to generate commercial and social value in parallel. We developed and applied a new conceptual framework in a descriptive analysis of observable indicators measuring commercial and social value for 91 programs registered in the Access Observatory. We found that most programs had features consistent with the generation of commercial value, directly through revenue generation (50.0%), or indirectly by creating competitive advantage (70.3%). We also found that most programs were implemented in countries where the company has commercial products registered (85.5%). While many programs had features consistent with the generation of social value, it was difficult to ascertain the level of that value because most did not share data (83.5%) and had not been evaluated (74.7%). Future efforts by the global health community and the pharmaceutical industry should focus on strengthening measurement and reporting on commercial and social indicators of industry-led access programs.
    MeSH term(s) Drug Industry ; Global Health ; Humans ; Social Values
    Language English
    Publishing date 2022-05-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2820935-7
    ISSN 2328-8620 ; 2328-8620
    ISSN (online) 2328-8620
    ISSN 2328-8620
    DOI 10.1080/23288604.2022.2057831
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  4. Article ; Online: Trends in HIV prevalence, incidence, and progress towards the UNAIDS 95-95-95 targets in Malawi among individuals aged 15-64 years: population-based HIV impact assessments, 2015-16 and 2020-21.

    Payne, Danielle / Wadonda-Kabondo, Nellie / Wang, Alice / Smith-Sreen, Joshua / Kabaghe, Alinune / Bello, George / Kayigamba, Felix / Tenthani, Lyson / Maida, Alice / Auld, Andrew / Voetsch, Andrew C / Jonnalagadda, Sasi / Brown, Kristin / West, Christine A / Kim, Evelyn / Ogollah, Francis / Farahani, Mansoor / Dobbs, Trudy / Jahn, Andreas /
    Mirkovic, Kelsey / Nyirenda, Rose

    The lancet. HIV

    2023  Volume 10, Issue 9, Page(s) e597–e605

    Abstract: Background: In 2014, UNAIDS set the goal of ending the AIDS epidemic by 2030 through the achievement of testing and treatment cascade targets. To evaluate progress achieved and highlight persisting gaps in HIV epidemic control in Malawi, we aimed to ... ...

    Abstract Background: In 2014, UNAIDS set the goal of ending the AIDS epidemic by 2030 through the achievement of testing and treatment cascade targets. To evaluate progress achieved and highlight persisting gaps in HIV epidemic control in Malawi, we aimed to compare key indicators (prevalence, incidence, viral load suppression, and UNAIDS 95-95-95 targets) from the 2015-16 and 2020-21 Malawi Population-based HIV Impact Assessment (PHIA) survey results.
    Methods: The Malawi PHIAs were nationally representative, cross-sectional surveys with a two-stage cluster sampling design. The first survey was conducted between Nov 27, 2015, and Aug 26, 2016; the second survey was conducted between Jan 15, 2020, and April 26, 2021. Our analysis included survey participants aged 15-64 years. Participants were interviewed and a 14 mL blood sample was collected and tested for HIV infection using the national rapid testing algorithm. For each survey, we estimated key HIV epidemic indicators and achievement of 95-95-95 targets. The risk ratio (RR) of the indicators between surveys were computed and considered significant at a confidence level of 0·05. All results were weighted, and self-reported awareness and treatment status were adjusted to account for detection of antiretrovirals.
    Findings: Our analysis included 17 187 participants aged 15-64 years in 2015-16 and 21 208 in 2020-21 who participated in the surveys and blood draw. In the 2020-21 survey, 88·4% (95% CI 86·7-90·0) of people living with HIV were aware of their HIV-positive status; of those aware, 97·8% (97·1-98·5) were on antiretroviral therapy; and of those on treatment, 96·9% (95·9-97·7) were virally suppressed. Between surveys, the national HIV prevalence decreased significantly from 10·6% (10·0-11·2) to 8·9% (8·4-9·5) with RR 0·85 (95% CI 0·78-0·92; p<0·0001). The annual HIV incidence decreased from 0·37% (0·20-0·53) to 0·22% (0·11-0·34) with RR 0·61 (95% CI 0·31-1·20; p=0·15). The population viral load suppression increased from 68·3% (66·0-70·7) in 2015-16 to 87·0% (85·3-88·5) in 2020-21 (RR 1·27 [95% CI 1·22-1·32]; p<0·0001).
    Interpretation: These results suggest that Malawi had already surpassed the UNAIDS viral load suppression target for 2030 (85·7%) by 2020-21. Through strategies and evidence-informed interventions implemented in the last half decade, especially scale-up of effective HIV treatment, Malawi has made tremendous progress, including decreasing HIV prevalence and incidence and achieving both the second and third 95 targets ahead of 2030. To address the first 95, efforts in HIV diagnosis should focus on males and younger age groups. There is a continued need for effective linkage to care, retention on antiretroviral therapy, and adherence support to maintain and build on progress.
    Funding: US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.
    MeSH term(s) Male ; Humans ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Acquired Immunodeficiency Syndrome/epidemiology ; Prevalence ; Incidence ; Malawi/epidemiology ; Cross-Sectional Studies ; Viral Load
    Language English
    Publishing date 2023-08-13
    Publishing country Netherlands
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ISSN 2352-3018
    ISSN (online) 2352-3018
    DOI 10.1016/S2352-3018(23)00144-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Comparison of COVID-19 Pandemic Waves in 10 Countries in Southern Africa, 2020-2021.

    Smith-Sreen, Joshua / Miller, Bridget / Kabaghe, Alinune N / Kim, Evelyn / Wadonda-Kabondo, Nellie / Frawley, Alean / Labuda, Sarah / Manuel, Eusébio / Frietas, Helga / Mwale, Anne C / Segolodi, Tebogo / Harvey, Pauline / Seitio-Kgokgwe, Onalenna / Vergara, Alfredo E / Gudo, Eduardo S / Dziuban, Eric J / Shoopala, Naemi / Hines, Jonas Z / Agolory, Simon /
    Kapina, Muzala / Sinyange, Nyambe / Melchior, Michael / Mirkovic, Kelsey / Mahomva, Agnes / Modhi, Surbhi / Salyer, Stephanie / Azman, Andrew S / McLean, Catherine / Riek, Lul P / Asiimwe, Fred / Adler, Michelle / Mazibuko, Sikhatele / Okello, Velephi / Auld, Andrew F

    Emerging infectious diseases

    2022  Volume 28, Issue 13, Page(s) 93–104

    Abstract: We used publicly available data to describe epidemiology, genomic surveillance, and public health and social measures from the first 3 COVID-19 pandemic waves in southern Africa during April 6, 2020-September 19, 2021. South Africa detected regional ... ...

    Abstract We used publicly available data to describe epidemiology, genomic surveillance, and public health and social measures from the first 3 COVID-19 pandemic waves in southern Africa during April 6, 2020-September 19, 2021. South Africa detected regional waves on average 7.2 weeks before other countries. Average testing volume 244 tests/million/day) increased across waves and was highest in upper-middle-income countries. Across the 3 waves, average reported regional incidence increased (17.4, 51.9, 123.3 cases/1 million population/day), as did positivity of diagnostic tests (8.8%, 12.2%, 14.5%); mortality (0.3, 1.5, 2.7 deaths/1 million populaiton/day); and case-fatality ratios (1.9%, 2.1%, 2.5%). Beta variant (B.1.351) drove the second wave and Delta (B.1.617.2) the third. Stringent implementation of safety measures declined across waves. As of September 19, 2021, completed vaccination coverage remained low (8.1% of total population). Our findings highlight opportunities for strengthening surveillance, health systems, and access to realistically available therapeutics, and scaling up risk-based vaccination.
    Language English
    Publishing date 2022-12-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid2813.220228
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4778: Show issues Location:
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