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How do we maximise global HIV treatment access? IAPAC Care Continuum Guidelines make recommendations
Gus Cairns, 2015-11-09 08:40:00
IAPAC, the International Association of Practitioners in
AIDS Care, has issued a set of guidelines that aims to establish a common set of
best practices to ensure that as many people living with HIV as possible are diagnosed,
cared for, receive treatment and achieve undetectable viral loads.
The IAPAC Care Continuum Optimisation Guidelines are
intended to back up the 2013 and 2015
World Health Organization (WHO) treatment guidelines, which now recommend antiretroviral therapy (ART)
for everyone diagnosed with HIV, and the 90/90/90
UNAIDS strategy, which aims to have 72.9% of all people with HIV on treatment
and non-infectious by 2020.
The IAPAC guidelines are based on 1047 different
articles that provide evidence to back up their 36 recommendations. The comprehensive
literature search and editing process behind the guidelines took nearly two
years and has had to be revised continually as new evidence has come in.
Fifty-seven people were involved in the writing and editing process.
The guidelines address different steps of the so-called HIV ‘care cascade’,
which analyses the percentage of people with HIV who are taking HIV treatment and have a suppressed viral load as the product of the proportion diagnosed, the proportion of those in
medical care, the proportion of those on ART, and the proportion of those with a suppressed viral load. It also looks at general improvements that need to be made
in the HIV care environment and in the monitoring and surveillance of HIV. It
has a couple of additional appendices of unmet research needs and on special
considerations for certain populations, but makes an exception for adolescents,
whom it includes as a special section in the main recommendations.