Catàleg general VIH/sida
HIV treatment cascade in HIV incarcerated patients in Mexico City 2014
ResumIntroduction: In 2011, Centers for Disease Control and Prevention (CDC) published the first HIV treatment cascade with data from 2008 and sets the basis to implement health policy in the areas of opportunity to stop the epidemic . Approximately 40,000 people are interned in the prison system in Mexico City, and the estimated HIV prevalence is 1%. In order to improve survival rates, quality of life and reduce the transmission of the infection, we have to look at the timely diagnosis, linkage and retention of patients in medical care and obviously prevention and treatment (highly active antiretroviral therapy (HAART)). Incarcerated persons with HIV have particular characteristics that define them: overcrowding, multiple sex partners, drug use, psychiatric conditions, antisocial personalities, low education levels, etc. Having HIV patients concentrated in the same place with supervised ARV daily dosage intake results in better adherence, retention in care and thus better virology control decreasing infection probability. Materials and methods: It is a retrospective study. We used data from the National System for Logistics Administration and Surveillance of ARV in Mexico (SALVAR in Spanish) up to the 31 December 2014, the database of the CIENI/CENSIDA and the database of the HIV Prison Programme in Mexico City. Criteria for inclusion: Incarcerated male patients with HIV infection in Mexico City during 2014 in Santa Martha Acatitla Penitentiary. Results: We started 2014 with 184 patients, adding 60 new patients throughout the year, 13 recidivists, 67 were freed and 9 died. At 31 December 2014, 206 HIV patients remained incarcerated, of which 92.2% (190) are linked and retained to health care (concen- trated in the prison of Santa Martha Acatitla), of which 87.4% are on HAART, with 72.8% under virology control (VL B200) and 63.1% undetectable (VLB40) (Figure 1). Twenty-one percent (60) initiated HAART in the previous six months, 5.2% (10) initiated their HAART protocol, in virology failure 2.1% (4), 1% (2) with persistent low grade viraemia (VL B1000) and 2.1% (4) with blip. Of the 67 patients that were freed, 91% (61) continued their medical treatment at the Condesa Specialized Clinic. Conclusions: It is necessary to strengthen the diagnosis of HIV in prison settings. Linkage and retention in medical care is covered in this model (HIV Programme in Prisons), alongside working with improving adherence to HAART in order to increase the levels of undetectability. The model of supervised daily dosage has given partial effective results given that the ARV is provided daily but it does not guarantee that the patients swallow the pills. Another important problem is how to link 100% of patients to ambulatory care once they obtain their freedom. The HIV Programme in Prisons of Mexico City is effective and can be replicated in different penitentiary systems in other states and countries, but not in the general population. (Extraído del documento)
Descàrrega/sol·licitud de document
Versió digital consultable a Sida Studi
- Any de publicació:
- Descripció física:
-  p.
- Tipus de document:
- Col·loquis i ponències
- Póster presentado en el congreso HIV Drug Therapy 2015 Americas, celebrado en México del 16 al 18 de abril de 2015.