Ten year trends in community HIV viral load in Barbados: implications for treatment as prevention.

<h4>Background</h4>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 Load...

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Autores principales:	R Clive Landis, Songee Lynn Branch-Beckles, Shawna Crichlow, Ian R Hambleton, Anton Best
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fcfee77a85394c4a8c7db3050924175e
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spelling	oai:doaj.org-article:fcfee77a85394c4a8c7db3050924175e2021-11-18T07:54:08ZTen year trends in community HIV viral load in Barbados: implications for treatment as prevention.1932-620310.1371/journal.pone.0058590https://doaj.org/article/fcfee77a85394c4a8c7db3050924175e2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23520523/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.R Clive LandisSongee Lynn Branch-BecklesShawna CrichlowIan R HambletonAnton BestPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e58590 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q R Clive Landis Songee Lynn Branch-Beckles Shawna Crichlow Ian R Hambleton Anton Best Ten year trends in community HIV viral load in Barbados: implications for treatment as prevention.
description	<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.
format	article
author	R Clive Landis Songee Lynn Branch-Beckles Shawna Crichlow Ian R Hambleton Anton Best
author_facet	R Clive Landis Songee Lynn Branch-Beckles Shawna Crichlow Ian R Hambleton Anton Best
author_sort	R Clive Landis
title	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_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_sort	ten year trends in community hiv viral load in barbados: implications for treatment as prevention.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/fcfee77a85394c4a8c7db3050924175e
work_keys_str_mv	AT rclivelandis tenyeartrendsincommunityhivviralloadinbarbadosimplicationsfortreatmentasprevention AT songeelynnbranchbeckles tenyeartrendsincommunityhivviralloadinbarbadosimplicationsfortreatmentasprevention AT shawnacrichlow tenyeartrendsincommunityhivviralloadinbarbadosimplicationsfortreatmentasprevention AT ianrhambleton tenyeartrendsincommunityhivviralloadinbarbadosimplicationsfortreatmentasprevention AT antonbest tenyeartrendsincommunityhivviralloadinbarbadosimplicationsfortreatmentasprevention
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Ten year trends in community HIV viral load in Barbados: implications for treatment as prevention.

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