-Epidemiology and HIV care cascade

Linkage, retention, treatment, adherence

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Low-level HIV viremia: Definitions, predictors, mechanisms, and clinical outcomes

-+*Download pdf Questions What are the factors associated with low-level HIV viremia? What are its possible mechanisms and clinical outcomes?  Key take-home messages The definitions of optimal viral suppression, low-level viremia, blips, virologic failure, and recommended management approaches to low-level viremia vary greatly across studies and clinical guidelines. There is controversy regarding the clinical implications …

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Immediate initiation of antiretroviral therapy (ART) after HIV diagnosis

-+*Download pdf Questions What are the best practices (including successes and challenges) of immediate initiation of ART after HIV testing and diagnosis? Key take-home messages The benefits of beginning antiretroviral therapy (ART) soon after HIV diagnosis include improved health outcomes across a wide variety of settings (1–5) as well as decreased long term  healthcare costs …

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Impact of universal coverage for antiretroviral therapy (ART) on health outcomes

-+*Download pdf Question What are the benefits of universal antiretroviral therapy (ART) coverage on individual and population level health outcomes?  Key take-home messages As of 2017, the annual cost of single-tablet antiretrovirals (ART) in Ontario was estimated to be CAD 15,552 according to the Ontario Drug Benefit Formulary (1, 2). Universal, no-cost ART for all …

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Impact of nonadherence to antiretroviral therapy (ART) on population-level health outcomes

-+*Download pdf Questions What is the impact of nonadherence to antiretroviral therapy (ART) on population-level health outcomes?  Key take-home messages Several studies analyze overall healthcare costs, pharmacy costs, and cost savings among people living with HIV relative to level of ART adherence (1–5). Generally, adherence to ART appears to predict levels of healthcare utilization, with …

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Interventions for immigrant Latino men who have sex with men along the HIV prevention and treatment cascade

-+*Download pdf Question What is the latest evidence regarding interventions for immigrant Latino men who have sex with men along the HIV prevention and treatment cascade?  Key take-home messages Among reported HIV cases with a known race/ethnicity in Canada in 2017, 6.3% were among individuals from Latin America (1). In 2018, Latinx persons in the …

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HIV self-testing in high-income settings: Acceptability, potential benefits and harms, issues related to linkage to care, interventions to increase HIV self-testing

-+*Download pdf Questions What is the current evidence in high-income settings on HIV self-testing related to acceptability, potential benefits and harms, issues related to the linkage to care after a positive test, and interventions to increase HIV self-testing?  Key take-home messages HIV self-testing has the potential to increase rates of HIV testing and is acceptable …

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Unmet needs of Indigenous peoples living with HIV

-+*Download pdf Questions What are the unmet needs of Indigenous peoples living with HIV? What interventions, strategies, and programs have been used to address these needs?  Key take-home messages In 2016, First Nations, Métis, and Inuit peoples accounted for 4.9% of the Canadian population but represented 11.3% of all new HIV infections (1). When considering …

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Strategies to link people with undiagnosed HIV infection to HIV testing, care, and prevention services

-+*Download pdf Questions What strategies have been successful at linking people with undiagnosed HIV infection to HIV testing, care, and prevention services?  Key take-home messages A variety of strategies have shown promise for identifying individuals with undiagnosed HIV and engaging them with HIV testing using clinical, community-based, network-based, and self-directed approaches. Various service delivery models …

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Out-of-pocket costs associated with HIV in publicly funded high-income health care settings

-+*Download pdf Question What out-of-pocket costs are associated with aging among people living with HIV?  Key take-home messages The aging of the people living with HIV in care is leading to increased HIV care costs (1). There is considerable inter-jurisdictional heterogeneity in the cost-sharing policies for antiretrovirals across Canada’s public drug programs (2). Out-of-pocket costs …

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Methods to estimate the number of people living with undiagnosed HIV

-+*Download pdf Questions How do we know how many people are living with undiagnosed HIV infection? What population groups make up people living with undiagnosed HIV infection?  Key take-home messages At the end of 2016, the Public Health Agency of Canada estimated that 14% of 63,110 individuals living with HIV in Canada were undiagnosed (1). …

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