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Beyond viral suppression of HIV - the new quality of life frontier

2016Journal article Open access
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dc.contributor.authorLazarus, Jeffrey V.
dc.contributor.authorSafreed-Harmon, Kelly
dc.contributor.authorBarton, Simon E.
dc.contributor.authorCostagliola, Dominique
dc.contributor.authorDedes, Nikos
dc.contributor.authorValero, Julia del Amo
dc.contributor.authorGatell, Jose M.
dc.contributor.authorBaptista-Leite, Ricardo
dc.contributor.authorMendão, Luís
dc.contributor.authorPorter, Kholoud
dc.contributor.authorVella, Stefano
dc.contributor.authorRockstroh, Jürgen Kurt
dc.date.accessioned2021-06-09T16:05:19Z
dc.date.available2021-06-09T16:05:19Z
dc.date.issued2016
dc.description.abstractBackground: In 2016, the World Health Organization (WHO) adopted a new Global Health Sector Strategy on HIV for 2016-2021. It establishes 15 ambitious targets, including the '90-90-90' target calling on health systems to reduce under-diagnosis of HIV, treat a greater number of those diagnosed, and ensure that those being treated achieve viral suppression. Discussion: The WHO strategy calls for person-centered chronic care for people living with HIV (PLHIV), implicitly acknowledging that viral suppression is not the ultimate goal of treatment. However, it stops short of providing an explicit target for health-related quality of life. It thus fails to take into account the needs of PLHIV who have achieved viral suppression but still must contend with other intense challenges such as serious non-communicable diseases, depression, anxiety, financial stress, and experiences of or apprehension about HIV-related discrimination. We propose adding a 'fourth 90' to the testing and treatment target: ensure that 90 % of people with viral load suppression have good health-related quality of life. The new target would expand the continuum-of-services paradigm beyond the existing endpoint of viral suppression. Good health-related quality of life for PLHIV entails attention to two domains: comorbidities and self-perceived quality of life. Conclusions: Health systems everywhere need to become more integrated and more people-centered to successfully meet the needs of virally suppressed PLHIV. By doing so, these systems can better meet the needs of all of their constituents - regardless of HIV status - in an era when many populations worldwide are living much longer with multiple comorbidities.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1186/s12916-016-0640-4pt_PT
dc.identifier.eid85007425671
dc.identifier.issn1741-7015
dc.identifier.pmid27334606
dc.identifier.urihttp://hdl.handle.net/10400.14/33561
dc.identifier.wos000378676100001
dc.language.isoengpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAIDSpt_PT
dc.subjectHealth policypt_PT
dc.subjectHealth systemspt_PT
dc.subjectHIVpt_PT
dc.titleBeyond viral suppression of HIV - the new quality of life frontierpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.titleBMC Medicinept_PT
oaire.citation.volume14pt_PT
person.familyNameLazarus
person.familyNameSafreed-Harmon
person.familyNamePorter
person.givenNameJeffrey
person.givenNameKelly
person.givenNameKholoud
person.identifier827688
person.identifier.orcid0000-0001-9618-2299
person.identifier.orcid0000-0003-4312-7389
person.identifier.orcid0000-0002-9226-6206
person.identifier.ridR-6248-2018
person.identifier.ridU-2288-2018
person.identifier.scopus-author-id55431519100
person.identifier.scopus-author-id20434848100
person.identifier.scopus-author-id7202104963
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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relation.isAuthorOfPublicationacfca3da-ab50-45af-854c-e63f384d9089
relation.isAuthorOfPublicatione49bcd1c-7940-463c-88ca-eb0384a9811e
relation.isAuthorOfPublication.latestForDiscovery8c104829-d770-4073-bab7-64e803822bf7

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