TY - JOUR
T1 - Trends and Sex Differences in Access to HIV Care with Scale Up of National HIV Treatment Guidelines in Pune, India
AU - Raichur, Priyanka
AU - Salvi, Sonali Pankaj
AU - Sangle, Shashikala
AU - Chavan, Amol
AU - Nimkar, Smita
AU - Gawande, Gajanan
AU - Rewari, Bharat
AU - Mathad, Jyoti
AU - Mcintire, Katherine
AU - Gupta, Amita
AU - Marbaniang, Ivan
AU - Mave, Vidya
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported through a grant from amfAR, The Foundation for AIDS Research with support from the National Institute of Health’s National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Cancer Institute, National Institute of Mental Health, National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907) and the NIH-funded Johns Hopkins Baltimore-Washington-India Clinical Trials Unit for NIAID Networks [UM1AI069465 to Amita Gupta]. The content and views expressed are those of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above.
Funding Information:
The authors would like to thank National AIDS Control Organisation (NACO) and the staff at the Byramjee Jeejeebhoy Government Medical College–Sassoon General Hospital ART Center who were involved in data collection. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported through a grant from amfAR, The Foundation for AIDS Research with support from the National Institute of Health’s National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Cancer Institute, National Institute of Mental Health, National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907) and the NIH-funded Johns Hopkins Baltimore-Washington-India Clinical Trials Unit for NIAID Networks [UM1AI069465 to Amita Gupta]. The content and views expressed are those of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020
Y1 - 2020
N2 - Test and treat is the current global standard, yet sex differences persist in access to HIV care. We assessed the differences in presentation and antiretroviral therapy (ART) uptake by sex and ART-eligibility period among ART-naive adults registered at a public ART center in India. Four ART eligibility periods were defined by programmatically determined CD4 criteria (periods I-IV: CD4 <200, <350, ≤500 cells/μL, and any CD4) between January 2005 and December 2017. Of 23 957 participants, 12 510 were male. Men consistently presented with lower median CD4 count (period I-IV, P <.05) and higher median age (period I-III, P <.001) than women. From period I to IV, median age increased in women (P <.0001), ART initiation time decreased in both sexes (P <.001), and median CD4 remained <200 cells/µL in men. Advanced HIV disease and increasing age at presentation are persistent sex-specific trends which warrant innovative HIV testing strategies in both sexes.
AB - Test and treat is the current global standard, yet sex differences persist in access to HIV care. We assessed the differences in presentation and antiretroviral therapy (ART) uptake by sex and ART-eligibility period among ART-naive adults registered at a public ART center in India. Four ART eligibility periods were defined by programmatically determined CD4 criteria (periods I-IV: CD4 <200, <350, ≤500 cells/μL, and any CD4) between January 2005 and December 2017. Of 23 957 participants, 12 510 were male. Men consistently presented with lower median CD4 count (period I-IV, P <.05) and higher median age (period I-III, P <.001) than women. From period I to IV, median age increased in women (P <.0001), ART initiation time decreased in both sexes (P <.001), and median CD4 remained <200 cells/µL in men. Advanced HIV disease and increasing age at presentation are persistent sex-specific trends which warrant innovative HIV testing strategies in both sexes.
KW - HIV/AIDS
KW - India
KW - age at presentation
KW - antiretroviral therapy guidelines
KW - sex differences
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U2 - 10.1177/2325958220931735
DO - 10.1177/2325958220931735
M3 - Article
C2 - 32573318
AN - SCOPUS:85086771153
SN - 2325-9574
VL - 19
JO - Journal of the International Association of Providers of AIDS Care
JF - Journal of the International Association of Providers of AIDS Care
ER -