Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention

BACKGROUND: Treatment as prevention is a paradigm in HIV medicine which describes the public health benefit of antiretroviral therapy (ART). It is based on research showing substantial reductions in the risk of HIV transmission in persons with optimally suppressed HIV-1 Viral Loads (VL). The present...

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Autores principales: Landis, R. Clive, Branch-Beckles, Songee Lynn, Crichlow, Shawna, Hambleton, Ian R., Best, Anton
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592800/
https://www.ncbi.nlm.nih.gov/pubmed/23520523
http://dx.doi.org/10.1371/journal.pone.0058590
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author Landis, R. Clive
Branch-Beckles, Songee Lynn
Crichlow, Shawna
Hambleton, Ian R.
Best, Anton
author_facet Landis, R. Clive
Branch-Beckles, Songee Lynn
Crichlow, Shawna
Hambleton, Ian R.
Best, Anton
author_sort Landis, R. Clive
collection PubMed
description BACKGROUND: Treatment as prevention is a paradigm in HIV medicine which describes the public health benefit of antiretroviral therapy (ART). It is based on research showing substantial reductions in the risk of HIV transmission in persons with optimally suppressed HIV-1 Viral Loads (VL). The present study describes ten year VL trends at the national HIV treatment unit and estimates VL suppression at a population level in Barbados, a Caribbean island with a population of 277,000, an estimated adult HIV prevalence of 1.2%, and served by a single treatment unit. METHODS: The national HIV treatment centre of the Barbados Ministry of Health has a client VL database extending back to inception of the clinic in 2002 (n = 1,462 clients, n = 17,067 VL measurements). Optimal VL suppression was defined at a threshold value of ≤200 viral copies/mL. RESULTS: Analysis of VL trends showed a statistically significant improvement in VL suppression between 2002 to 2011, from 33.6% of clients achieving the 200 copies/mL threshold in 2002 to 70.3% in 2011 (P<0.001). Taking into account the proportion of clients alive and in care and on ART, the known diagnosed HIV population in Barbados, and estimates of unknown HIV infections, this translates into an estimated 26.2% VL suppression at a population level at the end of 2010. CONCLUSIONS: We have demonstrated a significant trend towards optimal VL suppression in clients utilizing the services of the national HIV treatment program in Barbados over a 10-year period. Estimates of VL suppression at a population level are similar to reports in developed countries that applied similar methodologies and this could suggest a public health benefit of ART in minimizing the risk of sexual transmission of HIV. Continued efforts are warranted to extend HIV testing to hidden populations in Barbados and linking infected persons to care earlier in their disease.
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spelling pubmed-35928002013-03-21 Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention Landis, R. Clive Branch-Beckles, Songee Lynn Crichlow, Shawna Hambleton, Ian R. Best, Anton PLoS One Research Article BACKGROUND: Treatment as prevention is a paradigm in HIV medicine which describes the public health benefit of antiretroviral therapy (ART). It is based on research showing substantial reductions in the risk of HIV transmission in persons with optimally suppressed HIV-1 Viral Loads (VL). The present study describes ten year VL trends at the national HIV treatment unit and estimates VL suppression at a population level in Barbados, a Caribbean island with a population of 277,000, an estimated adult HIV prevalence of 1.2%, and served by a single treatment unit. METHODS: The national HIV treatment centre of the Barbados Ministry of Health has a client VL database extending back to inception of the clinic in 2002 (n = 1,462 clients, n = 17,067 VL measurements). Optimal VL suppression was defined at a threshold value of ≤200 viral copies/mL. RESULTS: Analysis of VL trends showed a statistically significant improvement in VL suppression between 2002 to 2011, from 33.6% of clients achieving the 200 copies/mL threshold in 2002 to 70.3% in 2011 (P<0.001). Taking into account the proportion of clients alive and in care and on ART, the known diagnosed HIV population in Barbados, and estimates of unknown HIV infections, this translates into an estimated 26.2% VL suppression at a population level at the end of 2010. CONCLUSIONS: We have demonstrated a significant trend towards optimal VL suppression in clients utilizing the services of the national HIV treatment program in Barbados over a 10-year period. Estimates of VL suppression at a population level are similar to reports in developed countries that applied similar methodologies and this could suggest a public health benefit of ART in minimizing the risk of sexual transmission of HIV. Continued efforts are warranted to extend HIV testing to hidden populations in Barbados and linking infected persons to care earlier in their disease. Public Library of Science 2013-03-08 /pmc/articles/PMC3592800/ /pubmed/23520523 http://dx.doi.org/10.1371/journal.pone.0058590 Text en © 2013 Landis et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Landis, R. Clive
Branch-Beckles, Songee Lynn
Crichlow, Shawna
Hambleton, Ian R.
Best, Anton
Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention
title Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention
title_full Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention
title_fullStr Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention
title_full_unstemmed Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention
title_short Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention
title_sort ten year trends in community hiv viral load in barbados: implications for treatment as prevention
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592800/
https://www.ncbi.nlm.nih.gov/pubmed/23520523
http://dx.doi.org/10.1371/journal.pone.0058590
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