10 results found
Kim S-H, Gerver SM, Fidler S, et al., 2014, Adherence to antiretroviral therapy in adolescents living with HIV: systematic review and meta-analysis, AIDS, Vol: 28, Pages: 1945-1956, ISSN: 0269-9370
Objective: Adolescent and young adult (AYA) populations (12–24 years) representover 40% of new HIV infections globally. Adolescence is sometimes characterized byhigh-risk sexual behaviour and a lack of engagement with healthcare services that canaffect adherence to antiretroviral therapy (ART). Despite adherence to ART beingcritical in controlling viral replication, maintaining health and reducing onward viraltransmission, there are limited data on ART adherence amongst AYA globally. Weundertook a systematic review and meta-analysis of published studies reportingadherence to ART for AYA living with HIV.Design and methods: Searches included Embase, Medline and PsychINFO databasesup to 14 August 2013. Eligible studies defined adequate adherence as at least 85% onself-report or undetectable blood plasma virus levels. A random effects meta-analysiswas performed and heterogeneity examined using meta-regression.Results: We identified 50 eligible articles reporting data from 53 countries and 10 725patients. Using a pooled analysis of all eligible studies, 62.3% [95% confidence interval(CI) 57.1–67.6; I2 : 97.2%] of the AYA population were adherent to therapy. The lowestaverage ART adherence was in North America [53% (95% CI 46–59; I2 : 91%)], Europe[62% (95% CI 51–73; I2 : 97%)] and South America [63% (95% CI 47–77; I2 : 85%]and, with higher levels in Africa [84% (95% CI 79–89; I2 : 93%)] and Asia [84% (95% CI77–91; I2 : 0%].Conclusion: Review of published literature from Africa and Asia indicate more than70% of HIV-positive AYA populations receiving ART are adherent to therapy and lowerrates of adherence were shown in Europe and North America at 50–60%. The globaldiscrepancy is probably multifactorial reflecting differences between focused andgeneralised epidemics, access to healthcare and funding.
Elmahdi R, Gerver SM, Guillen GG, et al., 2014, Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines, Sexually Transmitted Infections, Vol: 90, Pages: 119-124, ISSN: 1368-4973
Objectives: To quantify the extent to which guideline recommendations for routine testing for HIV are adhered to outside of genitourinary medicine (GUM), sexual health (SH) and antenatal clinics.Methods: A systematic review of published data on testing levels following publication of 2008 guidelines was undertaken. Medline, Embase and conference abstracts were searched according to a predefined protocol. We included studies reporting the number of HIV tests administered in those eligible for guideline recommended testing. We excluded reports of testing in settings with established testing surveillance (GUM/SH and antenatal clinics). A random effects meta-analysis was carried out to summarise level of HIV testing across the studies identified.Results: Thirty studies were identified, most of which were retrospective studies or audits of testing practice. Results were heterogeneous. The overall pooled estimate of HIV test coverage was 27.2% (95% CI 22.4% to 32%). Test coverage was marginally higher in patients tested in settings where routine testing is recommended (29.5%) than in those with clinical indicator diseases (22.4%). Provider test offer was found to be lower (40.4%) than patient acceptance of testing (71.5%).Conclusions: Adherence to 2008 national guidelines for HIV testing in the UK is poor outside of GUM/SH and antenatal clinics. Low levels of provider test offer appear to be a major contributor to this. Failure to adhere to testing guidelines is likely to be contributing to late diagnosis with implications for poorer clinical outcomes and continued onwards transmission of HIV. Improved surveillance of HIV testing outside of specialist settings may be useful in increasing adherence testing guidelines.
Gerver SM, Xu F, Tian L, et al., 2011, Incidence Rate of Herpes Simplex Virus type 2 (HSV-2) in the US, 1988-2008, International Society for Sexually Transmitted Disease Research
Background: HSV-2 infection remains a major public health problem in the US, where the prevalence is 16.2% in persons aged 14-49. In this report, we provide national estimates of new HSV-2 infections in the US and examine trends in incidence over the past two decades.Methods: A simple catalytic model was used to estimate HSV-2 force of infection (FOI), defined as the incidence of HSV-2 in the susceptible population, from National Health and Nutrition Examination Surveys (NHANES) in the US from 1988 through 2008. HSV-2 serology was included in the nationally representative surveys during 1988-1994 (NHANES III) and in continuous NHANES from 1999-2008. Incidence rates and trends over time were estimated by age, sex and race/ethnic group for non-Hispanic whites, non-Hispanic blacks, and Mexican-Americans.Results: HSV-2 FOI rates were highest in non-Hispanic blacks and lowest in non-Hispanic whites, with the FOI among 25 year old non-Hispanic black women more than 13 times greater than white men of the same age. Rates were highest between ages 25-35 years for all sex-race/ethnicity groups (peak in non-Hispanic white and black women aged 25 years, in non-Hispanic white and black men aged 35 years and in Mexican-American women in their early-thirties) except for Mexican-American men, for whom there was less variation in FOI by age. Over the last twenty years, age-adjusted FOI rates were stable for the sex-race/ethnicity groups examined except for non-Hispanic white and Mexican-American women, in which there were decreases after 2002 and 2001, respectively. FOI rates were lower in men than women among non-Hispanic blacks and Mexican-Americans, and in non-Hispanic whites prior to 2002. Overall, the estimated number of new HSV-2 infections in 2007-2008, among these three groups, aged 14-49 years, was in excess of 750,000, with 48% (~360,000) occurring in women and 52% (~392,000) in men. Nearly half (45%) of all infections occurred in persons under 25 years old (34% and 57
Gerver SM, Easterbrook PJ, Anderson M, et al., 2011, Sexual risk behaviours and sexual health outcomes among heterosexual black Caribbeans: comparing sexually transmitted infection clinic attendees and national probability survey respondents, INTERNATIONAL JOURNAL OF STD & AIDS, Vol: 22, Pages: 85-90, ISSN: 0956-4624
- Author Web Link
- Citations: 11
Gerver SM, Chadborn TR, Ibrahim F, et al., 2010, High rate of loss to clinical follow up among African HIV-infected patients attending a London clinic: a retrospective analysis of a clinical cohort, JOURNAL OF THE INTERNATIONAL AIDS SOCIETY, Vol: 13
- Author Web Link
- Citations: 31
Anderson M, Elam G, Gerver SM, et al., 2010, "It took a piece of me": initial responses to a positive HIV diagnosis by Caribbean people in the UK, AIDS Care, Vol: 22, Pages: 1493-1498
Anderson M, Elam G, Gerver SM, et al., 2009, Liminal identities: Caribbean men who have sex with men in London, UK, Culture, Health & Sexuality, Vol: 11, Pages: 315-330
Anderson M, Solarin I, Gerver S, et al., 2009, The LIVITY Study: research Challenges and Strategies for Engaging with the Black Caribbean Community in a Study of HIV Infection, International Journal of Social Research Methodology, Vol: 12, Pages: 197-209
Anderson M, Elam G, Solarin I, et al., 2009, Coping with HIV: Caribbean people in the United Kingdom, Qualitative Health Research, Vol: 19, Pages: 1060-1075
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