A picture is worth a thousand words

Maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts

Keri N. Althoff, Peter F. Rebeiro, David B. Hanna, Denis Padgett, Michael A. Horberg, Beatriz Grinsztejn, Alison G. Abraham, Robert Hogg, M. John Gill, Marcelo J. Wolff, Angel Mayor, Anita Rachlis, Carolyn Williams, Timothy R. Sterling, Mari M. Kitahata, Kate Buchacz, Jennifer E. Thorne, Carina Cesar, Fernando M. Cordero, Sean B. Rourke & 4 others Juan Sierra-Madero, Jean W. Pape, Pedro Cahn, Catherine McGowan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction: Maps are powerful tools for visualization of differences in health indicators by geographical region, but multicountry 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/mm3. 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.

Original languageEnglish (US)
Article number20707
JournalJournal of the International AIDS Society
Volume19
Issue number1
DOIs
StatePublished - Apr 4 2016

Fingerprint

Central America
South America
Acquired Immunodeficiency Syndrome
Epidemiology
Research Design
HIV
Research
Mexico
Viral Load
Haiti
Peru
Argentina
Brazil
Honduras
Quality of Health Care
Chile
North America
Primary Health Care
Therapeutics
Health

Keywords

  • Antiretroviral therapy
  • CD4 T-lymphocyte count
  • Central America
  • HIV indicators
  • HIV RNA suppression
  • Implementation science
  • Map
  • North America
  • Retention in care
  • South America

ASJC Scopus subject areas

  • Infectious Diseases
  • Public Health, Environmental and Occupational Health

Cite this

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.; 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.

In: Journal of the International AIDS Society, Vol. 19, No. 1, 20707, 04.04.2016.

Research output: Contribution to journalArticle

Althoff, KN, Rebeiro, PF, Hanna, DB, Padgett, D, Horberg, MA, Grinsztejn, B, Abraham, AG, Hogg, R, Gill, MJ, Wolff, MJ, Mayor, A, Rachlis, A, Williams, C, Sterling, TR, Kitahata, MM, Buchacz, K, Thorne, JE, Cesar, C, Cordero, FM, Rourke, SB, Sierra-Madero, J, Pape, JW, Cahn, P & McGowan, C 2016, '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 AIDS Society, vol. 19, no. 1, 20707. https://doi.org/10.7448/IAS.19.1.20707
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. / A picture is worth a thousand words : Maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts. In: Journal of the International AIDS Society. 2016 ; Vol. 19, No. 1.
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AU - Hanna, David B.

AU - Padgett, Denis

AU - Horberg, Michael A.

AU - Grinsztejn, Beatriz

AU - Abraham, Alison G.

AU - Hogg, Robert

AU - Gill, M. John

AU - Wolff, Marcelo J.

AU - Mayor, Angel

AU - Rachlis, Anita

AU - Williams, Carolyn

AU - Sterling, Timothy R.

AU - Kitahata, Mari M.

AU - Buchacz, Kate

AU - Thorne, Jennifer E.

AU - Cesar, Carina

AU - Cordero, Fernando M.

AU - Rourke, Sean B.

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KW - CD4 T-lymphocyte count

KW - Central America

KW - HIV indicators

KW - HIV RNA suppression

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KW - Map

KW - North America

KW - Retention in care

KW - South America

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