Advancing the long-term well-being of people living with HIV

Date:
July 21, 2021
Source:
CUNY Graduate School of Public Health and Health Policy
Summary:
A global multidisciplinary group of HIV experts has developed a
consensus statement identifying the key issues health systems
must address in order to move beyond the longtime emphasis on
viral suppression to instead deliver integrated, person-centered
healthcare for people living with HIV throughout their lives.



FULL STORY ========================================================================== Since antiretroviral therapy (ART) for HIV was introduced in 1996,
AIDS-related morbidity and mortality has declined significantly. People
living with HIV are now expected to live nearly as long as people without
HIV. Despite these advances, those living with HIV often report poor
well-being and health-related quality of life.


==========================================================================
To guide stakeholders in improving health system responses to achieve
the best possible long-term health outcomes for people living with HIV,
a global multidisciplinary group of HIV experts led by CUNY SPH Senior
Scholar Jeffrey Lazarus and including Distinguished Professor Denis Nash
and Associate Professor Diana Romero developed a consensus statement identifying the key issues health systems must address in order to move
beyond the longtime emphasis on viral suppression to instead deliver integrated, person-centered healthcare for people living with HIV
throughout their lives.

Following a rigorous, multi-stage Delphi process, the research team
established a diverse panel of experts with expertise in the long-term
health needs of people living with HIV. The panel reviewed the literature
on multimorbidity and stigma and discrimination in order to identify
priority issues to incorporate in the Delphi process to develop a
consensus statement.

"An important strength of this consensus statement is that it was
generated through this rigorous process, incorporating quantitative and qualitative data from experts from over 20 countries," says Dr. Romero.

The panel found that multimorbidity, health-related quality of life,
and stigma and discrimination continue to be major issues for people
living with HIV, including those who have achieved viral suppression
and in particular those from marginalized populations.

"These factors can lead to depression, social isolation and barriers in accessing health and support services," says Dr. Lazarus, who is also
associate professor at the Barcelona Institute for Global Health. "Many
of these issues are not currently addressed in HIV monitoring, strategies
or guideline." 'There is ample evidence that addressing things like
mental health, stigma reduction, quality of life, and in many settings,
housing and food security, will also improve HIV outcomes like adherence
to antiretroviral medications and viral suppression," Dr. Nash says. "The
field of HIV implementation science can play a key role in assessing the
impact of strategies integrated into HIV service delivery to mitigate
these issues." The World Health Organization (WHO) and UNAIDS should
create new HIV monitoring processes and guidelines, and Member States
should commit to report on the indicators and implement policies to
enhance health system performance and ensure the long-term well-being of
the millions of people around the world living with HIV, the authors note.

========================================================================== Story Source: Materials provided by CUNY_Graduate_School_of_Public_Health_and_Health_Policy.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jeffrey V. Lazarus, Kelly Safreed-Harmon, Adeeba Kamarulzaman, Jane
Anderson, Ricardo Baptista Leite, Georg Behrens, Linda-Gail Bekker,
Sanjay Bhagani, Darren Brown, Graham Brown, Susan Buchbinder,
Carlos Caceres, Pedro E. Cahn, Patrizia Carrieri, Georgina Caswell,
Graham S.

Cooke, Antonella d'Arminio Monforte, Nikos Dedes, Julia del Amo,
Richard Elliott, Wafaa M. El-Sadr, Mari'a Jose' Fuster-Ruiz
de Apodaca, Giovanni Guaraldi, Tim Hallett, Richard Harding,
Margaret Hellard, Shabbar Jaffar, Meaghan Kall, Marina Klein,
Sharon R. Lewin, Ken Mayer, Jose A. Pe'rez- Molina, Doreen Moraa,
Denise Naniche, Denis Nash, Teymur Noori, Anton Pozniak, Reena
Rajasuriar, Peter Reiss, Nesrine Rizk, Ju"rgen Rockstroh, Diana
Romero, Caroline Sabin, David Serwadda, Laura Waters. Consensus
statement on the role of health systems in advancing the long-term
well- being of people living with HIV. Nature Communications,
2021; 12 (1) DOI: 10.1038/s41467-021-24673-w ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/07/210721120648.htm

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