From Hospital to the Community: Redesigning the Human Immunodeficiency Virus (HIV) Clinical Service Model to Respond to an Outbreak of HIV Among People Who Inject Drugs

An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless heal...

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Detalles Bibliográficos
Autores principales: Metcalfe, Rebecca, Ragonnet-Cronin, Manon, Bradley-Stewart, Amanda, McAuley, Andrew, Stubbs, Harrison, Ritchie, Trina, O’Hara, Regina, Trayner, Kirsten, Glover, Claire, Laverty, Lynn, Sills, Laura, Brown, Kathryn, Gunson, Rory, Campbell, John, Milsoevic, Catriona, Anderson, Patricia, Peters, S Erica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Supplement Articles
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467274/
https://www.ncbi.nlm.nih.gov/pubmed/32877546
http://dx.doi.org/10.1093/infdis/jiaa336
Descripción
Sumario:An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.

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