TY - JOUR
T1 - A picture is worth a thousand words
T2 - Maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts
AU - Althoff, Keri N.
AU - Rebeiro, Peter F.
AU - Hanna, David B.
AU - Padgett, Denis
AU - Horberg, Michael A.
AU - Grinsztejn, Beatriz
AU - Abraham, Alison G.
AU - Hogg, Robert
AU - Gill, M. John
AU - Wolff, Marcelo J.
AU - Mayor, Angel
AU - Rachlis, Anita
AU - Williams, Carolyn
AU - Sterling, Timothy R.
AU - Kitahata, Mari M.
AU - Buchacz, Kate
AU - Thorne, Jennifer E.
AU - Cesar, Carina
AU - Cordero, Fernando M.
AU - Rourke, Sean B.
AU - Sierra-Madero, Juan
AU - Pape, Jean W.
AU - Cahn, Pedro
AU - McGowan, Catherine
N1 - Funding Information:
The NA-ACCORD and collaborating cohorts were supported by grants U01-AI069918, U01-AA013566, U01-AA020790, U01-AI31834, U01-AI34989, U01-AI34993, U01-AI34994, U01-AI35004, U01-AI35039, U01-AI35040, U01-AI35041, U01-AI35042, UM1-AI35043, U01-AI37613, U01-AI37984, U01-AI38855, U01-AI38858, U01-AI42590, U01-AI68634, U01-AI68636, U01-AI69432, U01-AI69434, U01-DA036935, U01-HD32632, U10-EY08052, U10-EY08057, U10-EY08067, U24-AA020794, U54-MD007587, UL1-RR024131, UL1-TR000083, F31-DA037788, F31-DA030254, G12-MD007583, K01-AI071754, K01-AI093197, K23-EY013707, K24-DA00432, K24-AI065298, KL2-TR000421, MO1-RR-00052, N02-CP55504, P30-AI027763, P30-AI094189, P30-AI27757, P30-AI27767, P30-AI036219, P30-AI50410, P30-AI54999, P30-MH62246, R01-AA16893, R01-CA165937, R01-DA04334, R01-DA11602, R01-DA12568, R24-AI067039, R56-AI102622, Z01-CP010214, and Z01-CP010176 from the National Institutes of Health, USA; contract CDC200-2006-18797 from the Center's for Disease Control and Prevention, USA; contract 90047713 from the Agency for Healthcare Research and Quality, USA; contract 90051652 from the Health Resources and Services Administration, USA; grants TGF-96118, HCP-97105, CBR-86906, CBR-94036 from the Canadian Institutes of Health Research, Canada; Canadian Institutes of Health Research (CIHR) New Investigator award (A. Burchell); Ontario Ministry of Health and Long Term Care; and the Government of Alberta, Canada. Additional support was provided by the Intramural Research Program of the National Cancer Institute, and National Institutes of Health.
PY - 2016/4/4
Y1 - 2016/4/4
N2 - Introduction: Maps are powerful tools for visualization of differences in health indicators by geographical region, but multicountry maps of HIV indicators do not exist, perhaps due to lack of consistent data across countries. Our objective was to create maps of four HIV indicators in North, Central, and South American countries. Methods: Using data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and the Caribbean, Central, and South America network for HIV epidemiology (CCASAnet), we mapped median CD4 at presentation for HIV clinical care, proportion retained in HIV primary care, proportion prescribed antiretroviral therapy (ART), and the proportion with suppressed plasma HIV viral load (VL) from 2010 to 2012 for North, Central, and South America. The 15 Canadian and US clinical cohorts and 7 clinical cohorts in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru represented approximately 2-7% of persons known to be living with HIV in these countries. Results: Study populations were selected for each indicator: median CD4 at presentation for care was estimated among 14,811 adults; retention was estimated among 87,979 adults; ART use was estimated among 84,757 adults; and suppressed VL was estimated among 51,118 adults. Only three US states and the District of Columbia had a median CD4 at presentation ≥350 cells/mm3. Haiti, Mexico, and several states had ≥85% retention in care; lower (50-74%) retention in care was observed in the US West, South, and Mid-Atlantic, and in Argentina, Brazil, and Peru. ART use was highest (90%) in Mexico. The percentages of patients with suppressed VL in the US South and Northeast were lower than in most of Central and South America. Conclusions: These maps provide visualization of gaps in the quality of HIV care and allow for comparison between and within countries as well as monitoring policy and programme goals within geographical boundaries.
AB - Introduction: Maps are powerful tools for visualization of differences in health indicators by geographical region, but multicountry maps of HIV indicators do not exist, perhaps due to lack of consistent data across countries. Our objective was to create maps of four HIV indicators in North, Central, and South American countries. Methods: Using data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and the Caribbean, Central, and South America network for HIV epidemiology (CCASAnet), we mapped median CD4 at presentation for HIV clinical care, proportion retained in HIV primary care, proportion prescribed antiretroviral therapy (ART), and the proportion with suppressed plasma HIV viral load (VL) from 2010 to 2012 for North, Central, and South America. The 15 Canadian and US clinical cohorts and 7 clinical cohorts in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru represented approximately 2-7% of persons known to be living with HIV in these countries. Results: Study populations were selected for each indicator: median CD4 at presentation for care was estimated among 14,811 adults; retention was estimated among 87,979 adults; ART use was estimated among 84,757 adults; and suppressed VL was estimated among 51,118 adults. Only three US states and the District of Columbia had a median CD4 at presentation ≥350 cells/mm3. Haiti, Mexico, and several states had ≥85% retention in care; lower (50-74%) retention in care was observed in the US West, South, and Mid-Atlantic, and in Argentina, Brazil, and Peru. ART use was highest (90%) in Mexico. The percentages of patients with suppressed VL in the US South and Northeast were lower than in most of Central and South America. Conclusions: These maps provide visualization of gaps in the quality of HIV care and allow for comparison between and within countries as well as monitoring policy and programme goals within geographical boundaries.
KW - Antiretroviral therapy
KW - CD4 T-lymphocyte count
KW - Central America
KW - HIV RNA suppression
KW - HIV indicators
KW - Implementation science
KW - Map
KW - North America
KW - Retention in care
KW - South America
UR - http://www.scopus.com/inward/record.url?scp=84963542603&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84963542603&partnerID=8YFLogxK
U2 - 10.7448/IAS.19.1.20707
DO - 10.7448/IAS.19.1.20707
M3 - Article
C2 - 27049052
AN - SCOPUS:84963542603
SN - 1758-2652
VL - 19
JO - Journal of the International AIDS Society
JF - Journal of the International AIDS Society
IS - 1
M1 - 20707
ER -