dc.contributor.author | Flynn, Andrew G | |
dc.contributor.author | Meya, David B | |
dc.contributor.author | Hullsiek, Katherine Huppler | |
dc.contributor.author | Rhein, Joshua | |
dc.contributor.author | Williams, Darlisha A | |
dc.contributor.author | Musubire, Abdu | |
dc.contributor.author | Morawski, Bozena M | |
dc.contributor.author | Taseera, Kabanda | |
dc.contributor.author | Sadiq, Alisat | |
dc.contributor.author | Ndyatunga, Liberica | |
dc.contributor.author | Roediger, Mollie | |
dc.contributor.author | Rajasingham, Radha | |
dc.contributor.author | Bohjanen, Paul R | |
dc.contributor.author | Muzoora, Conrad | |
dc.contributor.author | Boulware, David R | |
dc.date.accessioned | 2022-05-12T10:27:10Z | |
dc.date.available | 2022-05-12T10:27:10Z | |
dc.date.issued | 2017 | |
dc.identifier.citation | Flynn, A. G., Meya, D. B., Hullsiek, K. H., Rhein, J., Williams, D. A., Musubire, A., ... & Boulware, D. R. (2017, April). Evolving failures in the delivery of human immunodeficiency virus care: lessons from a Ugandan meningitis cohort 2006–2016.In Open Forum Infectious Diseases (Vol. 4, No. 2). Oxford University Press. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/1919 | |
dc.description.abstract | Background: Investments in HIV care in sub-Saharan Africa have increased the number of people aware of their status and receiving antiretroviral therapy (ART), yet HIV/AIDS mortality remains high.
Methods: We performed retrospective analysis of three sequential prospective cohorts of HIV-infected Ugandan adults presenting with AIDS and meningitis from 2006-2009, 2010-2012 and 2013-2016. Participants were categorized as: 1) unknown HIV status; 2) known HIV+ without ART; 3) known HIV+ with previous ART. We further categorized 2006 and 2013 cohort participants by duration of HIV-status knowledge and of ART receipt.
Results: We screened 1353 persons with suspected meningitis. Cryptococcus was the most common pathogen (63%). Over the decade we observed an absolute increase of 37% in HIV status knowledge and 59% in antecedent ART receipt at screening. 2006 cohort participants were new/recent HIV diagnoses (65%) or known HIV+ but not receiving ART (35%). Many 2013 cohort participants were new/recent HIV diagnoses (34%) and known HIV+ with <1-month ART (20%), but a significant proportion were receiving ART 1-4 months (11%) and >4 months (30%). 4% discontinued ART. From 2010 to 2016, meningitis cases per month increased by 33%.
Conclusions: While improved HIV screening and ART access remain much-needed interventions in resource-limited settings, greater investment in viral suppression and opportunistic infection care among the growing HIV-infected population receiving ART is essential to reducing ongoing AIDS mortality. | en_US |
dc.description.sponsorship | National Institute of Neurologic Diseases and Stroke (NINDS) and the Fogarty International Center (R01NS086312, R25TW009345, K01TW010268), Grand Challenges Canada (S4-0296-01), and National Institute of Allergy and Infectious Diseases (U01AI089244, T32AI055433, K24AI096925). | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | In Open Forum Infectious Diseases | en_US |
dc.subject | HIV/AIDS | en_US |
dc.subject | Antiretroviral therapy | en_US |
dc.subject | HIV care continuum | en_US |
dc.subject | Cryptococcal meningitis | en_US |
dc.subject | Sub-Saharan Africa | en_US |
dc.title | Evolving failures in the delivery of HIV care: Lessons from a Ugandan meningitis cohort 2006-2016 | en_US |
dc.title.alternative | HIV care failures in Ugandans with AIDS | en_US |
dc.type | Article | en_US |