REFLECTIONS ON ADHERENCE 2017 MICHAEL STIRRATT PHD NIMH DIVISION OF AIDS RESEARCH JUNE
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1 REFLECTIONS ON ADHERENCE 2017 MICHAEL STIRRATT PHD NIMH DIVISION OF AIDS RESEARCH JUNE
2 CONFLICT OF INTEREST DISCLOSURE Michael Stirratt, Ph.D. Has no real or apparent conflicts of interest to report
3 RAPPORTUER CLUB
4 500+ delegates 450+ abstracts submitted More presentations than I can count
5 CONFERENCE THEME ACTIONING THE VISION
6 THE VISION
7 GOALS PRECONFERENCE 1 // Abstract Granich
8 Cesar Nunez Plenary
9 THE CORE FAST-TRACK PRINCIPLES Building solid political commitment for ambitious prevention, testing, treatment and rights targets for 2020 and beyond. Set national and sub-national targets, informed by global targets Achieving detailed, localized understanding of country epidemics and drivers, and focus services and resources on locations and populations with the largest HIV burden. Stopping what does not work. Quickly introduce new evidence-based approaches. Broaden options for service delivery to reduce the burden on strained health systems and extend the reach of services, including greater use of community-based approaches and new partnerships. Drastically quickening the pace and accelerate the scale up of services over the next five years. Delivering HIV services in the intensity and quality needed to reach the targets within the next five years. Implement the full complement of high-impact HIV services in prioritized locations and populations. Ensuring that services are people-centred. Repeal laws, reform policies and end practices that hold back a more effective and equitable AIDS response.
10 FAST TRACK PANEL: MONDAY JUNE 5
11 MUGAVERO: PARTNERSHIPS ARE THE KEY FAMILY CLINIC
12 CASCADE BRIGADE
13
14 Percentage of participants HIV PREVENTION CONTINUUM AMONG NYC MSM ELIGIBLE FOR PREP * 100% 75% 50% 25% 0% 100% Eligible for PrEP 83% Provider visit, past 6 months 69% Sexual hx and provider visit, past 6 months 53% Discussed PrEP with provider, past 6 months 30% On PrEP, past 6 months ORAL #270 (EDELSTEIN): HIV PREVENTION CONTINUUM AMONG MSM IN NEW YORK CITY, SPRING 2016
15 BRUCE AGINS: ACTIONING CASCADES IN HEALTHCARE ORGANIZATIONS
16 BRUCE AGINS: ACTIONING CASCADES IN HEALTHCARE ORGANIZATIONS
17 HIV Treatment Cascade for Alabama (AL), 2016 Via Oral #185, Scott Batey 15,306 84% 86% 59% 63% HIVdiagnosed HIVinfected (est.) Linked to care Retained in care (last 12 mos) Suppressed viral load ( 200 copies/ml) Source: AL Department of Public Health (ADPH)
18 LET DATA LIGHT THE WAY
19 AMBASSADOR BIRX: REITER/KAPLAN MEMORIAL LECTURE Ambassador Birx, Reiter/Kaplan Memorial Lecture
20 AGE AND GENDER DISPARITIES IN THE CASCADE Ambassador Birx, Reiter/Kaplan Memorial Lecture
21 AGE AND GENDER DISPARITIES IN THE CASCADE Cesar Nunez, Opening Plenary Ambassador Birx, Reiter/Kaplan Memorial Lecture
22 Geographic Variability in Time from HIV Diagnosis to Viral Suppression in Alabama Richard P Rogers, 1 Tian Tang, 2 D Scott Batey, 3 Anthony Merriweather, 1 H Irene Hall, 4 Michael J Mugavero 3 ORAL #185
23 DEPARTMENT OF HEALTH RESOURCES FOR DATA GRETCHEN WEISS, NACCHO, PRE CON #1
24 Leanne Savola, City of Detroit Department of Health and Wellness Promotion Actioning the Evidence Discussion Panel, Monday 10am
25 Mark Nelson MD, Plenary: Why are there still such large gaps in coverage in the test and treat era?
26 DIVERSIFYING REGIMENS
27 WHO OPTS FOR DAILY VERSUS ON-DEMAND PRE-EXPOSURE PROPHYLAXIS? Zoe Greenwald, Oral #227, Clinique médicale l Actuel, Montréal, Québec, Canada
28 REGIMEN PREFERENCE EVOLVES Laurent Cotte, Intermittent PrEP Debate, Tuesday June 6
29 PSYCHOSOCIAL MOTIVATIONS AND BARRIERS FOR LONG-ACTING PREP AMONG CURRENT PREP USERS Poster #305: Sarit Golub
30 TECHNOLOGIC INTERVENTIONS
31 ORAL #275 Retention Adherence Adjusted OR* 2.73 (95% CI ) P=0.007 Adjusted OR* 2.06 (95% CI ) P=0.03
32 ORAL #163 SHORT MESSAGE SERVICE (SMS) REMINDERS IMPROVE PATIENT ON-TIME PILL PICK-UP OF THEIR ANTIRETROVIRAL MEDICINES IN NAMIBIA SAMSON S. MWINGA
33 ORAL #173 POSITIVE LINKS MOBILE APP TO SUPPORT PEOPLE LIVING WITH HIV WATCH THIS SPACE:
34 ORAL 276 EFFECTIVENESS OF A CELL PHONE COUNSELING INTERVENTION ON PMTCT RETENTION, ADHERENCE TO TREATMENT, AND UPTAKE OF EARLY INFANT DIAGNOSIS AND PREGNANCY RELATED SERVICES IN KISUMU, KENYA: A RANDOMIZED CONTROLLED STUDY
35 ORAL #220 #220 EFFECTS OF A REAL-TIME REMINDER INTERVENTION ON RETENTION IN HIV TREATMENT AMONG PREGNANT AND POSTPARTUM WOMEN IN A LOW-RESOURCE SETTING: THE UGANDA WISEMAMA STUDY
36 CHANGE CARE NOT JUST PEOPLE
37 SANDI MCCOY, ORAL #278: CONDITIONAL INCENTIVES Oral 278 (McCoy): Conditional cash incentives or food supplementation (contingent on visit attendance) improved MPR and reduces LTFU
38 SUSAN GRAHAM, ORAL #306: THE SHIKAMANA INTERVENTION TO SUPPORT ART ADHERENCE AND CARE ENGAGEMENT FOR KENYAN MSM MSM in Kenya Substantial stigma/discrimination Multicomponent intervention: MSM sensitivity training for medical providers Modified Next Step adherence counseling Peer Support (Washikaji) Mental health screening and support (peer/provider)
39 Culturally competent care for transgender individuals (Arianna Lint, Sunday Discussion Panel)
40 Tom Giordano Plenary
41 ORAL #201
42 Shannon Weber, Poster #165 Robert Grant, PrEP 2.0 Plenary
43 UNMET CHALLENGES
44 STIGMA AND DISCRIMINATION Worry, avoidance and discrimination in the last 12 months Mark Nelson MD, Plenary: Why are there still such large gaps in coverage in the test and treat era?
45 ORAL #158 Perceived discrimination in healthcare settings is associated with sub-optimal ART adherence Association mediated in a serial fashion by internalized stigma and by depressive symptoms, as hypothesized
46 YOUNG PEOPLE
47 PREP DISPARITIES
48 ADVANCING PREP USE Robert Grant Plenary: PrEP 2.0
49 Midnight Poonkasetwattana Scaling up PrEP
50 IN CONCLUSION
51
52
53
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