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A PICTURE IS WORTH A THOUSAND WORDS: MAPS OF HIV INDICATORS TO INFORM RESEARCH, PROGRAMS, AND POLICY FROM NA-ACCORD AND CCASANET CLINICAL COHORTS
Althoff, Keri N. et al. | Date Issued: 2016
Author
Althoff, Keri N.
Rebeiro, Peter F.
Hanna, David B.
Padgett, Denis
Horberg, Michael A.
Grinsztejn, Beatriz
Abraham, Alison G.
Hogg, Robert
Gill, M. John
Wolff, Marcelo J.
Mayor, Angel
Rachlis, Anita
Williams, Carolyn
Sterling, Timothy R.
Kitahata, Mari M.
Buchacz, Kate
Thorne, Jennifer E.
Cesar, Carina
Cordero, Fernando M.
Rourke, Sean B.
Sierra-Madero, Juan
Pape, Jean W.
Cahn, Pedro
McGowan, Catherine
NA-ACCORD
CCASAnet
Affilliation
Department of Epidemiology. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA.
Vanderbilt University. Department of Medicine. Nashville, TN, USA.
Albert Einstein College of Medicine. Department of Epidemiology and Population Health. Bronx, NY, USA.
Department of Internal Medicine. Infectious Disease Service. Instituto Hondureño de Seguridad Social. Tegucigalpa, Honduras.
Mid-Atlantic Permanente Research Institute. Kaiser Permanente Mid-Atlantic States. Rockville, MD, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Department of Epidemiology. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA.
British Columbia Centre for Excellence in HIV/AIDS. Vancouver, British Columbia, Canada.
University of Calgary. Department of Medicine. Calgary, Alberta, Canada.
Universidad de Chile and Fundación Arriarán. Facultad de Medicina. Departamento de Medicina. Santiago, Chile.
Universidad Central del Caribe. Department of Internal Medicine. Bayamón, Puerto Rico, USA.
University of Toronto. Sunnybrook Health Sciences Centre. Department of Medicine. Toronto, ON, Canada.
National Institute of Allergy and Infectious Diseases. Basic Science Program. Division of AIDS. Epidemiology. Rockville, MD, USA.
Vanderbilt University. Department of Medicine. Nashville, TN, USA.
University of Washington. Department of Medicine. Seattle, WA, USA.
Centers for Disease Control and Prevention. Division of HIV/AIDS Prevention. Atlanta, GA, USA.
University of Toronto. Sunnybrook Health Sciences Centre. Department of Medicine. Toronto, ON, Canada / University School of Medicine. Department of Ophthalmology. Johns Hopkins Baltimore, MD, USA.
Fundación Huésped, Buenos Aires. Investigaciones Clínicas. Argentina, USA.
Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. HIV Research Group. Lima, Peru.
University of Toronto. Department of Psychiatry. Toronto, Ontario, Canada.
Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico DF, Mexico.
Le Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes. Port-au-Prince, Haiti / Weill Cornell Medical College. Department of Medicine. New York, NY, USA.
Fundación Huésped. Investigaciones Clínicas. Buenos Aires, Argentina, USA.
Vanderbilt University. Department of Medicine. Nashville, TN, USA.
Abstract
Introduction: Maps are powerful tools for visualization of differences in health indicators by geographical region, but multi-country 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/mm(3). 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.
Keywords
Map
HIV indicators
CD4 T-lymphocyte count
Retention in care
Antiretroviral therapy
HIV RNA suppression
North America
Central America
South America
Implementation science
 
Publisher
John Wiley & Sons
Citation
ALTHOFF, Keri N. et al. A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts. Journal of the International Journal of the International AIDS Society, v. 19, n. 1, p. 1-7, Apr. 2016.
DOI
10.7448/IAS.19.1.20707
ISSN
1758-2652
Notes
Collaborators: North American Aids Cohort Collaboration on Research and Design (NA-ACCORD) and Caribbean, Central and South America Network for Hiv Epidemiology (CCASAnet): Gregory D Kirk, Constance A Benson, Ronald J Bosch, Stephen Boswell, Kenneth H Mayer, Chris Grasso, Robert S Hogg, P Richard Harrigan, Julio S G Montaner, Angela Cescon, Hasina Samji, John T Brooks, Kate Buchacz, Kelly A Gebo, Richard D Moore, Richard D Moore, Benigno Rodriguez, Michael A Horberg, Michael J Silverberg, Jennifer E Thorne, James J Goedert, Lisa P Jacobson, Gypsyamber D'Souza, Marina B Klein, Sean B Rourke, Ann N Burchell, Anita R Rachlis, Robert F Hunter-Mellado, Angel M Mayor, M John Gill, Steven G Deeks, Jeffrey N Martin, Pragna Patel, John T Brooks, Michael S Saag, Michael J Mugavero, James Willig, Joseph J Eron, Sonia Napravnik, Mari M Kitahata, Heidi M Crane, Daniel R Drozd, Timothy R Sterling, David Haas, Sally Bebawy, Megan Turner, Amy C Justice, Robert Dubrow, David Fiellin, Stephen J Gange, Kathryn Anastos, Richard D Moore, Michael S Saag, Stephen J Gange, Mari M Kitahata, Keri N Althoff, Rosemary G McKaig, Amy C Justice, Aimee M Freeman, Richard D Moore, Aimee M Freeman, Carol Lent, Mari M Kitahata, Stephen E Van Rompaey, Heidi M Crane, Daniel R Drozd, Liz Morton, Justin McReynolds, William B Lober, Stephen J Gange, Keri N Althoff, Alison G Abraham, Bryan Lau, Jinbing Zhang, Jerry Jing, Elizabeth Golub, Shari Modur, Cherise Wong, Brenna Hogan, Weiqun Tong, Bin Lin, Pedro Cahn, Beatriz Grinsztejn, Marcelo Wolff Reyes, Jean W Pape, Denis Padgett, Juan Sierra Madero, Eduardo Gotuzzo, Catherine McGowan, Pedro Cahn, Catherine McGowan.