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    HIV-tuberculosis co-infection is a global problem: resources need to be expanded and funding must be sustainable and predictable        PB IDI menyatakan bahwa kondom adalah alat kesehatan yang mampu mencegah penularan infeksi menular seksual (termasuk HIV) bila digunakan pada setiap kegiatan seks berisiko.        By enabling and empowering women to protect themselves and their partners with female condoms, we can begin saving lives and curbing the spread of HIV today.         Women need prevention now. They need access to the female condom and education on its use.        Indonesian AIDS Community (AIDS-INA) will use internet technologies for facilitating the dissemination and exchange of knowledge and experience in HIV/AIDS programme among all community members        Do you know that DFID provide £25 million in support of a large HIV and AIDS Programme in Indonesia started in 2005? Do you know where the fund have been allocated?        Apakah Menko KesRa atau Presiden SBY masih peduli terhadap penanggulangan penyakit menular, termasuk HIV-AIDS, TB, Malaria - di Indonesia? Indonesia sedang dalam kondisi sungguh sulit dengan dampak penularan yang terus meluas pada masyarakat yang miskin        Bila Konsep Akselerasi Upaya Penanggulangan HIV-AIDS di Indonesia tidak difahami dengan BENAR dan Berbasis evidence, maka TIDAK AKAN berhasil menahan laju epidemi HIV di Indonesia. Itu yang terjadi sekarang!        Further evidence to support a recommendation for exclusive breastfeeding by HIV-positive mothers in resource-limited settings        Deliver TB and HIV services in the context of fully functioning primary health care systems to ensure cases are detected, prevention is available and treatment accessible and sustained        Reach the most vulnerable populations with TB and HIV services Now!        The HIV service providers need to do : screening for TB and starting isoniazid preventive therapy if there is no sign of active TB.        To fight AIDS we must do more to fight TB (Nelson Mandella, 2004)        Violence makes women more susceptible to HIV infection and the fear of violent male reactions, physical and psychological, prevents many women from trying to find out more about it, discourages them from getting tested and stops them from getting treatmen        People at high risk of HIV exposure should be tested every three to six months in identifying recently infected people then we have to be able to counsel them to modify high-risk sexual behavior and desist from transmitting the virus        About half of new HIV cases occur when the person transmitting the virus is in the early stages of infection and unlikely to know if he or she is HIV-positive        HIV/AIDS Epidemic in Indonesia: not one ( single) epidemic but many (multiple) (riono, pandu)        Combating HIV-AIDS requires more than prevention and treatment. It requires improving the conditions under which people are free to choose safer life strategies and conditions.        Para pecandu yang butuh alat suntik (insul) steril, hubungi LSM setempat - Lihat pada Jejaring Layanan        Kurangi Dampak Akibat Bencana Napza dengan Upaya Pemulihan Pecandu yang komprehensif (metadon, Jarums steril, tes HIV dan Hep C, Pengobatan dan Dukungan)        Treatment without prevention is simply unsustainable! Pengobatan saja tanpa upaya pencegahan yang serius dan sistematik sama saja BOHONG!        1 Desember: keprihatinan global atas kegagalan kita!        Gunakan alat suntik steril untuk hindari penularan HIV dan Hepatitis        Pakai kondom pada setiap kegiatan seks berisiko, dapat mencegah penularan HIV        HIV tidak mudah menular dari satu orang ke orang lain        Komisi Penanggulangan AIDS (KPA) adalah institusi koordinasi BUKAN Pelaksana program atau Implementor!!        Profesi Kesehatan perlu terlibat dan dilibatkan secara aktif dalam upaya penanggulangan HIV-AIDS        Perluasan Masalah HIV-AIDS di Indonesia TIDAK mungkin dibatasi oleh wilayah administratif tertentu saja        Hindari diskriminasi dan stigmatisasi pada orang rawan dan orang yang telah terkena HIV        AIDS adalah kenyataan, lakukan tes HIV bila ingin tahu status anda        AIDS-INA - Sarana komunitas AIDS Indonesia untuk menyampaikan gagasan serta tukar informasi    

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"Diriku sendiri dan saudara2 yang sama2 berjuang.... fojus untuk sehat dan berbahagia beruntung kita diberikan cara penebusan dosa di dunia yang belum tentu kita akan sanggup menebusnya kalau di akhirat nanti. Untuk Mama ku dan saudara2 ku tercinta.... besar harapan mu untuk aku bahagia doa kalian yang menambah kekuatan.. mama aku tau mama ingin cucu dariku... aku tau mama selalu bertanya kapan krn ingin aku bahagia... aku tau mama selalu bertanya karena ketidak tauan mama tentang kondisiku... aku sedang berjuang Ma... aku berjanji tdk akan memberikan kesedihan saat papa tiada... makanya aku berjuang sendiri dan aku yakin... cucu yg kau dambakan bukan hal yg mustahil... kesehatan ku semakin membaik aku sudah bangkit dari keterpurukan mental krn bisikan syetan, Mama jangan km yang sehat ya. Tunggu aku dan menantu beserta cucu2 mu bersimpuh dalam pelukanmu... aku janji aku akan terus berjuang!!!"
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Kategori: Utama/Jurnal Ilmiah


Urutkan berdasarkan: Judul (A\D) Tanggal (A\D) Nilai (A\D) Popularitas (A\D)
Saat ini ditampilkan menurut: Judul (Z - A)


  Universal access to HIV/AIDS treatment for injecting drug users: Keeping the promise 
Deskripsi: The introduction of highly active antiretroviral therapy (ART) in the mid-1990s brought new hope for people living with HIV/AIDS. ART promised to make a fatal disease a manageable chronic illness. In the early years access to such treatment was limited to those living in rich countries. The cost of medicines was prohibitive for most, the treatment regimens were complex with multiple side effects, treatment needed to be monitored by specialised physicians with access to sophisticated laboratories and other health services, and patients needed to be living in stable and supportive environments. Any belief that treatment was only feasible for the rich and privileged was shattered in 1997 when Brazil became the ?rst developing country to provide ART through its public health system.

Despite the leadership of Brazil few other developing countries (exceptions included such countries as Argentina, Botswana, Chile, Senegal, Uganda and Thailand) committed to a similar public health response thereafter. As HIV-related mortality and morbidity plummeted in most high-income countries with the rapid expansion of ART, ever-increasing numbers of people were dying in low-and middle-income countries. Such disparities in access to life-saving treatment galvanised a global movement in support of rapid treatment scale up. On 22 September 2003, the World Health Organization (WHO), the UNAIDS Secretariat, and The Global Fund to Fight AIDS, Tuberculosis and Malaria declared the lack of access to ART as a global health emergency. In response, WHO and the UNAIDS Secretariat announced a global target to provide ART to three million people in low-and middleincome countries by 2005, the “3 by 5” target. A multi-partner response followed in many countries, involving governments, civil society, technical agencies and donors. In the 2 years of the initiative those receiving ART in low-and middleincome countries increased from an estimated 400,000 at the end of 2003 to 1.3 million by the end of 2005 (WHO, 2006). The success of “3 by 5” did much to mobilise political commitment for treatment scale-up, leading to a declaration from G8 leaders in July 2005 to support countries to scale
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  Self-reported side-effects of anti-retroviral treatment among IDUs: A 7-year longitudinal study 
Deskripsi: Abstract
The introduction of potent anti-retroviral treatment (ART) has transformed HIV disease into a chronic condition with the prospect, for the patient, of strict adherence to effective but life-long treatments. Within this framework, a major issue that can negatively affect adherence is the side-effects of the treatment. To date, studies documenting how individuals HIV-infected through drug injection (IDUs) experience ART-related side effects are sparse.

Longitudinal data collected from the APROCO-COPILOTE cohort have been used to compare the experience of ART-related side-effects who have been HIV-infected via injecting drug use and non-IDU patients. A 20-item list was used to collect self-reported side-effects over a 7-year follow up period.

Of 922 patients, 15% were IDUs. At any given visit, IDUs reported a signi?cantly higher number of side-effects and had approximately twice the risk of reporting any side effect than non-IDUs. Most commonly reported side-effects were dry skin, fatigue, vomiting, bone troubles, insomnia. After adjustment for social conditions, depressive symptoms, use of sleeping pills and time since HIV diagnosis, IDUs reported experiencing signi?cantly more side-effects than non-IDUs. Whether or not this is related to sensitivity to pain or to other comorbidities is dif?cult to establish.

Further research is needed to understand how substitution treatment can mediate the relationship between exposure to opioids and side¬effects. Providing appropriate care to reduce side-effects, thereby increasing adherence to ART in this population, remains a major challenge especially in those countries scaling up ART. Incorporating symptom management and improving access to analgesic medications within a model of comprehensive care for HIV-infected IDUs, could reduce the impact of drug-related and HIV-related harms and induce better long-term treatment outcomes and quality of life. © 2007 Elsevier B.V. All rights reserved.

Keywords: Side effects; Anti-retroviral treatment; HIV; Injecting drug users; Hyperalgesia; Pain
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  Pilot study for TB-HIV co-infection prevalence survey in Indonesia 
Deskripsi: Objective: To pilot and assess acceptability of unlinked anonymous testing and potential uptake of Voluntary Counselling and Testing (VCT) among tuberculosis (TB) patients in Jogjakarta, Indonesia and determine HIV prevalence among TB patients in the pilot area,
Method: We introduced unlinked anonymous HIV testing for TB patients attending Directly Observed Treatment, Short-course (DOTS) services between April-December 2006. Demographic characteristics were documented for all patients. Patients were additionally offered access to free VCT services. We used logistic regression to identify risk factors for HIV-positive test and for VCT non-interest.
Results: There were 1681 TB patients registered during the study period. Out of these, 989 (58.8%) accepted and undertook unlinked anonymous testing. The acceptance rate of unlinked anonymous testing among those who were offered was 77.9%. There were no significant differences between the two groups apart from districts. HIV prevalence in all TB tested patients was 1.9 (95% CI 1.6-2.2). Out of those offered VCT, 856 (86.6%) were not interested.
Conclusion: The prevalence of HIV among TB patients is higher than WHO estimate for Indonesia. There was high acceptance rate to unlinked anonymous testing and low interest toward VCT.

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  Obstacles in provision of ART to drug users in Central and Eastern Europe and Central Asia 
Deskripsi: Abstract
Central and Eastern Europe and Central Asia is currently the region with the fastest growing HIV epidemic, mainly among injecting drug users (IDUs). This study explored access to anti-retroviral (ARV) treatment among IDUs and evaluated obstacles to gaining access to treatment. Semistructured questionnaires were collected from 21 countries from agencies which deliver services to IDUs (N = 55), including AIDS centres, drug treatment institutions and Non-governmental Organisations. Results showed that there was poor access to ARV treatment for IDUs. The major obstacles reported were: limited range of institutions for the provision of ARVs, lack of treatment due to high cost of ARVs, lack of clear policies and regulations in providing treatment for IDUs, lack of infrastructure and trained staff to provide treatment, and in some countries, absence of mechanisms such as methadone substitution programmes to support IDUs receiving ARV. There is a need for human and capital resources to bring ARV treatment to IDU populations in the region. Regulations and treatment protocols need to be developed to address this particular group of HIV positive clients to insure better adherence and monitoring of clients with HCV co-infection. Integration of provision of ARV treatment with drug treatment and low-threshold services is advised. Substitution therapy should be advocated for in countries where it is not available or where access is limited. Finally, more research needs to be conducted to understand what will work best in each country, region or setting. © 2007 Elsevier B.V. All rights reserved.

Keywords: Central and Eastern Europe and Central Asia; HIV; Drug users; ARV
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  Integration and co-location of HIV/AIDS, tuberculosis and drug treatment services 
Deskripsi: Abstract
Injection drug use (IDU) plays a critical role in the HIV epidemic in several countries throughout the world. In these countries, injection drug users are at signi?cant risk for both HIV and tuberculosis, and active IDU negatively impacts treatment access, adherence and retention. Comprehensive strategies are therefore needed to effectively deliver preventive, diagnostic and curative services to these complex patient populations. We propose that developing co-located integrated care delivery systems should become the focus of national programmes as they continue to scale-up access to antiretroviral medications for drug users. Existing data suggest that such a programme will expand services for each of these diseases; increase detection of tuberculosis (TB) and HIV; improve medication adherence; increase entry into substance use treatment; decrease the likelihood of adverse drug events; and improve the effectiveness of prevention interventions. Key aspects of integration programmes include: co-location of services convenient to the patient; provision of effective substance use treatment, including pharmacotherapies; cross-training of generalist and specialist care providers; and provision of enhanced monitoring of drug–drug interactions and adverse side effects. Central to implementing this agenda will be fostering the political will to fund infrastructure and service delivery, expanding street-level outreach to IDUs, and training community health workers capable of cost effectively delivering these services. © 2007 Elsevier B.V. All rights reserved.

Keywords: HIV; AIDS; Injection drug use; Substance use; Tuberculosis; Health care integration; Health services; Prevention
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  HIV treatment access and scale-up for delivery of opiate substitution therapy with buprenorphine 
Deskripsi: Abstract
Background: Injection drug use (IDU) accounts for 70 percent of HIV cases in Ukraine. Until buprenorphine maintenance therapy (BMT) was introduced, few effective strategies aimed at achieving reduction in illicit drug use were available as a conduit to anti-retroviral therapy (ARV) among IDUs.
Description: In October 2005, BMT was scaled-up using Global Fund resources in six regions within Ukraine. Entry criteria included opioid dependence, HIV-1 seropositivity, age =18 years and reported interest in BMT. All sites included a multidisciplinary team. To date, 207 patients have been initiated on BMT.
Lessons learned: The existing infrastructure allows for further scale-up of and administration of BMT and the possibility of co-administration with ARV. The process for prescription and administration of buprenorphine and ARV is at times cumbersome and constrained by current regulations. Recommendations: More IDU need BMT to improve overall health outcomes. Central to expanding access will be legislative changes to existing drug policy. Moreover, the cost of buprenorphine is prohibitively expensive. Sustainable substitution therapy in Ukraine requires lower negotiated prices for buprenorphine, the addition of methadone, or both to the existing formulary for HIV+ drug users. © 2006 Elsevier B.V. All rights reserved.

Keywords: HIV/AIDS; Buprenorphine; Substitution therapy
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  Directly observed therapy programmes for ART amongst injection drug users in Vancouver 
Deskripsi: Abstract
The introduction of highly active anti-retroviral therapy (HAART) has produced dramatic reductions in HIV associated morbidity and mortality. However, this success has not been replicated amongst injection drug users (IDUs) and other marginalised groups largely due to reduced uptake and lower rates of access and adherence to anti-retrovirals (ARVs). Multi-disciplinary programmes have been developed to help support ARV treatment and HIV care amongst IDUs. We retrospectively analysed the rates of adherence and plasma viral load suppression amongst participants in two clinic-based programmes that began enrollment in 1998. Of the 297 clients, the mean age was 40.5 years, 73% were males, 44% were of Aboriginal ethnicity, and 85% were Hepatitis C co-infected. One hundred and forty-two (47%) started therapy with a CD4 count below 200 mm-3, and baseline plasma viral load was over 100,000 copies/ml in 73 (25%). Treatment interruptions of greater than 2 weeks occurred in 41% of the participants during follow-up. The overall rate of adherence to treatment was 84.5% during periods when known interruptions were not considered. Plasma viral load suppression was attained by 29% during the ?rst ARV regimen, although 83% had at least one fully suppressed plasma viral load recorded during follow-up. All cause mortality was 21% during the period of observation. The programmes initiated in Vancouver demonstrate the positive impact that a comprehensive DOT programme can have on ARV adherence, as well as highlight the challenges that remain. © 2006 Elsevier B.V. All rights reserved.

Keywords: Anti-retrovirals; Directly observed therapy; HIV/AIDS; Injection drug use
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  Antiretroviral HIV treatment and care for injecting drug users: An evidence-based overview 
Deskripsi: Abstract
AIDS-related mortality and the rate of progression to AIDS have dramatically decreased since the advent of highly active antiretroviral treatment (HAART). The overall bene?t from antiretroviral HIV treatment has, however, been lesser in HIV-infected injecting drug users (IDUs) than in other patient groups (e.g. men who have sex with men). Poorer outcomes in HIV-infected IDUs are related to a variety of factors, including increased rates of non-HIV-related deaths, hepatitis C, delayed access to effective treatment, lower adherence to care and treatment regimens, continuation of illicit drug use, depression and negative life events. The available evidence strongly suggests the need for the large-scale implementation of comprehensive treatment and care strategies for IDUs that include both treatment of drug dependence and HAART. © 2007 Published by Elsevier B.V.

Keywords: HIV treatment; Injecting drug use; Review
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Dimasukkan: 27-Sep-2007
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  Adherence to HIV treatment among IDUs and the role of opioid substitution treatment (OST) 
Deskripsi: Abstract
In the era of highly effective anti-retroviral therapy (ART), data show a signi?cant difference in treatment outcomes between injecting drug users (IDUs) and non-IDUs. Factors that may contribute to suboptimal treatment outcomes in IDUs include delayed access to ART, competing comorbid diseases, psychosocial barriers and poor long-term adherence to ART.

This review describes and compares several studies on adherence to ART and its correlates in HIV-infected individuals in general, then IDUs and ?nally those IDUs on opioid substitution treatment (OST). It highlights how ongoing drug use or OST can modify the pattern of these correlates.

The aim is to extend all the experience acquired from these studies in order to optimise both access to care and adherence in those countries where HIV infection is mainly driven by IDUs and where ART and OST are only starting to be scaled up. The role of OST in fostering access to care and adherence to ART together with the promising results achieved to date using modi?ed directly observed therapy (DOT) programs for patients taking methadone, allow us to emphasize the ef?cacy of a comprehensive care model which integrates substance dependence treatment, psychiatric treatment, social services, and medical treatment. The review concludes by suggesting areas of future research targeted at improving the understanding of both the role of perceived toxicity and patient-provider relationship for patients on ART and OST. © 2007 Elsevier B.V. All rights reserved.

Keywords: Adherence; Anti-retroviral treatment; HIV; Substitution treatment; Injecting drug users
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  Access, adherence, quality and impact of ARV provision to current and ex-IDU in Manipur (India) 
Deskripsi: Abstract
Objectives: This study aims to understand who is obtaining anti-retroviral therapy (ART) in Manipur, and to determine adherence, access, and impact amongst those who use it. It also explores the quality of these services, their impact and the level of user satisfaction.
Methods: A mixed method approach was used for this assessment involving direct observations, analysis of service statistics, and a semistructured survey (n = 226).
Results: Less than 5% of current injecting drug users (IDUs) were accessing ART (despite IDUs making up the single largest category affected by HIV in Manipur). Self-reported treatment adherence amongst patients is poor. Major factors in?uencing adherence are current alcohol use, the cost of ART, having attending any counselling in the last 6 months, income levels of below Indian Rupees (INR) 2000 and negative experience of side effects. Client satisfaction is associated with: duration of time spent with doctors, waiting time and how staff treat the patients. Service quality also requires improvement. A quarter of patients on ART perceive that it has bene?ted their health and report feeling well. Side effects were experienced by 61% of those on ART. Greater efforts to bring more active IDUs into treatment, whilst improving the manner in which ART is delivered in Manipur are required. © 2007 Elsevier B.V. All rights reserved.

Keywords: ART; IDUs; Adherence; Access; Manipur; India
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