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Current HIV/AIDS Reports

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19.02.2016 | The Science of Prevention (JD Stekler and J Baeten, Section Editors)

Cascade of Refusal—What Does It Mean for the Future of Treatment as Prevention in Sub-Saharan Africa?

verfasst von: Ingrid T. Katz, David R. Bangsberg

Erschienen in: Current HIV/AIDS Reports | Ausgabe 2/2016

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Abstract

Recent recommendations by the World Health Organization support treatment for all people living with HIV (PLWH) globally to be initiated at the point of testing. While there has been marked success in efforts to identify and expand treatment for PLWH throughout sub-Saharan Africa, the goal of universal treatment may prove challenging to achieve. The pre-ART phase of the care cascade from HIV testing to HIV treatment initiation includes several social and structural barriers. One such barrier is antiretroviral therapy (ART) treatment refusal, a phenomenon in which HIV-infected individuals choose not to start treatment upon learning their ART eligibility. Our goal is to provide further understanding of why treatment-eligible adults may choose to present for HIV testing but not initiate ART when indicated. In this article, we will discuss factors driving pre-ART loss and present a framework for understanding the impact of decision-making on early losses in the care cascade, with a focus on ART refusal.

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Titel: Cascade of Refusal—What Does It Mean for the Future of Treatment as Prevention in Sub-Saharan Africa?
verfasst von: Ingrid T. Katz
David R. Bangsberg
Publikationsdatum: 19.02.2016
Verlag: Springer US
Erschienen in: Current HIV/AIDS Reports / Ausgabe 2/2016
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-016-0309-9

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In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

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Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

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