China's Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of aids patients living mainly in impoverished rural regions of central China. With little experience in HIV/AI...
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China's Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of aids patients living mainly in impoverished rural regions of central China. With little experience in HIV/aids treatment and care and resource limitations, China's efforts to provide widespread access to free antiretroviral therapy has been a process fraught with difficulty. However, the Free ART Program is progressing from an emergency response to a standardized treatment and care system. The development of national guidelines, training programs, a laboratory support network, a national patient database, programs for special populations such as children and patients living with coinfections, and operational research has improved the scope and quality of the free treatment program. As of June 30,2005, a total of 19,456 patients in 28 provinces, autonomous regions, and special municipalities had received free *** stemming from the nature of China's health system and patient population persist, but with strong government support and a diverse set of resources, China has the capacity to overcome these challenges and to provide nationwide access to high quality treatment and care.
China’s Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of aids patients living mainly in impoverished rural regions of central China. With little experience in HIV/aids ...
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China’s Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of aids patients living mainly in impoverished rural regions of central China. With little experience in HIV/aids treatment and care and resource limitations, China’s efforts to provide widespread access to free antiretroviral therapy has been a process fraught with difficulty. However, the Free ART Program is progressing from an emergency response to a standardized treatment and care system. The development of national guidelines, training programs, a laboratory sup- port network, a national patient database, programs for special populations such as children and patients living with co- infections, and operational research has improved the scope and quality of the free treatment program. As of June 30, 2005, a total of 19,456 patients in 28 provinces, autonomous regions, and special municipalities had received free ART. Challenges stemming from the nature of China’s health system and patient population persist, but with strong govern- ment support and a diverse set of resources, China has the capacity to overcome these challenges and to provide nationwide access to high quality treatment and care.
The epidemiology of the HIV transmission in the United States has changed considerably since the epidemic began. Our increased understanding of the virus has fostered development of new treatments to prolong life, and...
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Background: To examine demographic and behavioral associations with self-reported health-related quality of life (HRQOL) among persons with HIV infection or aids. Methods: Analysis of interviews with persons ≥ 18 yea...
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Rapid tests to detect HIV antibodies have been widely used over the past decade. Many simple, rapid HIV tests demonstrate sensitivities and specificities comparable to those of enzyme immunoassays (EIAs) without the n...
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Rapid tests to detect HIV antibodies have been widely used over the past decade. Many simple, rapid HIV tests demonstrate sensitivities and specificities comparable to those of enzyme immunoassays (EIAs) without the need for sophisticated laboratory equipment and highly-trained technicians. Algorithms comprised of two or more rapid tests can also produce HIV test results as accurate as the EIA-Westem blot combination. Rapid assays that can be used with whole blood or oral fluid specimens have now been developed and make point-of-care (POC) HIV testing feasible. POC tests can make HIV testing accessible in areas with limited laboratory facilities and greatly reduce the number of persons who do not learn their test results. POC testing can also provide immediate test results that are needed to make decisions about antiretroviral prophylaxis for pregnant women in labor and for health care workers who have had occupational exposures to blood or body fluids. This review summarizes available data on the characteristics and performance of individual HIV rapid tests from independent evaluations, peer-reviewed journals, and conference abstracts and describes experiences with the POC use of rapid HIV tests for voluntary counseling and testing (VCT) and perinatal screening.
The objective of this study was to evaluate the cost-effectiveness of a state-of-the-art sexual-risk reduction intervention for high-risk men and women. The main intervention consisted of seven small-group sessions ba...
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The objective of this study was to evaluate the cost-effectiveness of a state-of-the-art sexual-risk reduction intervention for high-risk men and women. The main intervention consisted of seven small-group sessions based on well-established principles of cognitive-behavioral therapy. This intervention was compared with a single-session video-based risk reduction intervention. The main outcome measure was the incremental cost-utility ratio, which equals the additional cost per additional quality-adjusted life year (QALY) saved by the cognitive-behavioral intervention, in comparison with the video intervention. A mathematical model of HIV transmission was used to translate reported sexual behavior changes into estimates of the number of HIV infections averted by the interventions, and associated savings in QALYs and averted HIV-related medical costs. For women, the incremental cost-utility ratio equaled $32,688 per QALY saved, which indicates that the cognitive-behavioral intervention was cost-effective compared to the video intervention. For men, the incremental cost-utility ratio was slightly negative, suggesting that the cognitive-behavioral intervention was highly cost-effective, or even cost-saving, compared to the video intervention. This analysis indicates that both brief and intensive sexual risk reduction interventions for high-risk populations can be cost-effective.
Effective community-level HIV prevention strategies have the potential to reach large numbers of at-risk individuals at relatively small per-capita costs, and therefore to be highly cost-effective. We review the publi...
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Effective community-level HIV prevention strategies have the potential to reach large numbers of at-risk individuals at relatively small per-capita costs, and therefore to be highly cost-effective. We review the published literature on the cost-effectiveness of community-level HIV prevention interventions, including five studies of sexual behavior change interventions and seven risk reduction programs for injection drug users. Overall, these studies indicate that community-level strategies can be very cost-effective, and in many cases, actually save society money by averting the need for costly HIV/aids medical care.
Because resources to fund HIV prevention are limited, public health decision makers - such as health departments and HIV prevention community planning groups - need to know which prevention strategies are the most cos...
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Because resources to fund HIV prevention are limited, public health decision makers - such as health departments and HIV prevention community planning groups - need to know which prevention strategies are the most cost-effective. In the past several years, a number of studies have appeared in the literature that assess the cost-effectiveness of interventions to prevent the sexual transmission of HIV in the United States. Here, we comprehensively review 16 such studies and then outline an agenda for further research to advance the cost-effectiveness literature and to make the findings of these studies more useful for public health decision makers. The research summarized here provides compelling evidence that interventions to prevent sexual transmission of HIV can be highly cost-effective. Small-group, community-level, and outreach-based sexual risk reduction interventions, in particular, appear to be very efficient strategies for preventing the spread of HIV in moderate- to high-risk populations.
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