دورية أكاديمية
أعرض في EDS

Improved Indicators for Subnational Unmet Antiretroviral Therapy Need in the Health System: Updates to the Naomi Model in 2023.

التفاصيل البيبلوغرافية
العنوان: Improved Indicators for Subnational Unmet Antiretroviral Therapy Need in the Health System: Updates to the Naomi Model in 2023.
المؤلفون: Esra R; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom., Mmelesi M; UNAIDS, Gaborone, Botswana., Ketlogetswe AT; Centers for Disease Control and Prevention, Gaborone, Botswana., Wolock TM; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom., Howes A; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom.; Department of Mathematics, Imperial College London, London, United Kingdom., Nong T; Botswana Ministry of Health and Wellness, Gaborone, Botswana., Matlhaga MT; National AIDS and Health Promotion Agency, Gaborone, Botswana; and., Ratladi S; National AIDS and Health Promotion Agency, Gaborone, Botswana; and., Ramaabya D; Botswana Ministry of Health and Wellness, Gaborone, Botswana., Imai-Eaton JW; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom.; Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
المصدر: Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2024 Jan 01; Vol. 95 (1S), pp. e24-e33. Date of Electronic Publication: 2024 Jan 04.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 100892005 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1944-7884 (Electronic) Linking ISSN: 15254135 NLM ISO Abbreviation: J Acquir Immune Defic Syndr Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, Inc., c1999-
مواضيع طبية MeSH: HIV Infections*/drug therapy, Adult ; Humans ; Bayes Theorem ; Anti-Retroviral Agents/therapeutic use ; Botswana ; Government Programs
مستخلص: Background: Quantifying subnational need for antiretroviral therapy (ART) for HIV is challenging because people living with HIV (PLHIV) access health facilities in areas that may differ from their residence. We defined and demonstrated new indicators for PLHIV treatment needed to guide health system target setting and resource allocation.
Setting: Botswana.
Methods: We extended Naomi, a Bayesian small-area model for estimating district-level HIV indicators from national household survey and HIV service delivery data. We used model outputs for ART seeking probabilities in neighboring districts to define the "PLHIV (attending)" indicator representing the estimated number of PLHIV who would seek treatment at health facilities in a district, and "Untreated PLHIV attending" representing gaps in ART service provision. Botswana 2021 district HIV estimates were used to demonstrate new outputs and assess the sensitivity to uncertainty in district population sizes.
Results: Across districts of Botswana, estimated adult ART coverage in December 2021 ranged 90%-96%. In the capital city Gaborone, there were 50,400 resident PLHIV and 64,200 receiving ART, of whom 24% (95% CI: 20 to 32) were estimated to reside in neighboring districts. Applying ART attendance probabilities gave a "PLHIV attending" denominator of 68,300 and unmet treatment need of 4100 adults (95% CI: 3000 to 5500) for Gaborone health facilities. The facility-based "PLHIV attending" denominator was less-sensitive to fluctuations in district population size assumptions.
Conclusions: New indicators provided more consistent targets for HIV service provision, but are limited by ART data quality. This challenge will increase as treatment coverage reaches high levels and treatment gaps are smaller.
Competing Interests: The authors have no funding or conflicts of interest to disclose.
(Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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معلومات مُعتمدة: MR/R015600/1 United Kingdom MRC_ Medical Research Council
المشرفين على المادة: 0 (Anti-Retroviral Agents)
تواريخ الأحداث: Date Created: 20240105 Date Completed: 20240108 Latest Revision: 20240228
رمز التحديث: 20240228
مُعرف محوري في PubMed: PMC10769176
DOI: 10.1097/QAI.0000000000003324
PMID: 38180736
قاعدة البيانات: MEDLINE
الوصف
تدمد:1944-7884
DOI:10.1097/QAI.0000000000003324