As the only company solely focused on HIV, ViiV Healthcare is pioneering the way for HIV implementation science in the biopharmaceutical space.
We are committed to investing in implementation research alongside clinical efficacy trials to identify the best strategies for making a difference in the treatment and prevention of HIV.
In 2020, global statistics showed…
38 million people
living with HIV
1.5 million people
34% aren't successfully managing their HIV
Determining factors for successful implementation is necessary if we want to maximize the impact of available treatment and prevention strategies today and in the future. Implementation science can contribute to a better understanding of how to implement solutions and ensure that as many people benefit from the life-saving treatments and prevention medications for HIV.
Finding solutions to bridge the gap between clinical research and HIV care and prevention
Improving outcomes in HIV care and prevention – from increased testing, diagnosis, retention in care, and greater community viral load suppression – is a win-win for all, including individuals, public health community, researchers and industry.
We partner with researchers, public health leaders, academia, governments, community organizations, and others to increase the value and utilization of implementation research data with a clear focus on improving the lives of those affected by HIV and preventing acquisition of HIV.
- Global HIV & AIDS statistics-fact sheet. UNAIDS website. https://www.unaids.org/en/resources/fact-sheet
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We are committed to using implementation science to find solutions to ending the HIV epidemic in these priority areas:
Health-related quality of life
The development of highly effective medications for HIV treatment has led to substantial improvements in clinical and virologic outcomes for people living with HIV. For example, the clinical evidence shows that people living HIV cannot sexually transmit the virus to others once they are virally supressed, that is, by taking and adhering to antiretroviral therapy as prescribed.
Despite these impressive gains, the 4th 90 from the UNAIDS 2020 targets, where 90% of people living with HIV have a good health-related quality of life, was not achieved. Many people living with HIV and ageing with HIV experience poor health-related quality of life with regards to their mental, sexual and physical wellbeing.
Suboptimal health-related quality of life is driven be several factors including stigma, comorbidities, relationship challenges, social circumstances and structural inequalities. There is also evidence that gender differences exist in health-related quality of life among people living with HIV. We are committed to identifying and implementing solutions that improves health-related quality of life.
Stigma & discrimination
To end the AIDS epidemic by 2030, we believe that HIV-related stigma and discrimination must be eliminated. HIV-related stigma and discrimination negatively impact uptake and use of treatment and prevention methods, deter health-seeking behaviors, hinder prevention efforts and linkage to care and support, and disrupt HRQoL for people living with HIV.
Stigma is driven by lack of HIV knowledge, cultural and gender norms, economic inequalities, laws and regulations, and many more factors. Some individuals experience intersectional stigma due to prejudices related to their affiliations to multiple stigmatized identities.
High rates of HIV-related stigma and discrimination persist despite considerable efforts to combat it. We believe that implementation science is critical to the elimination of HIV-related stigma and discrimination.
Before additional HIV drugs were made available in 1996, life expectancy for individuals with HIV was 18 months post diagnosis⁴. HIV care and management have advanced significantly from the beginning of the epidemic, and today, people living with HIV (PLWH) who have access and adhere to their antiretroviral therapy (ART) have a similar life expectancy to HIV-negative people⁵. This has contributed to a significant proportion of people living with HIV in many countries being 50 years of age or older. This includes over half of the people living with HIV in the United States.
Many patients with HIV will live healthy lives into old age, but for some, ageing with HIV will present some specific challenges, including those of a physical, emotional, social, or functional nature. Examples of these changes include mental health issues, social isolation, loneliness, and stigma and discrimination, each potentially driven by different causes compared to younger populations. Similarly, physical needs including frailty may be present, as can issues relating to polypharmacy, comorbidities, and chronic inflammation. We are dedicated to supporting implementation research focused on closing gaps that are preventing people who are ageing with HIV from living healthy lives.
Although there was a 70% decline of the number of children who were diagnosed with HIV between 2000 and 2015, an unacceptably high number of children continues to become infected today.¹
Ending paediatric HIV remains an urgent global health priority. In 2015, UNAIDS and global partners outlined the Start Free, Stay Free, AIDS Free framework, with related targets, focused on eliminating new HIV infections. Start Free focuses on preventing children from acquiring HIV during pregnancy, birth and throughout the breastfeed period; Stay Free on preventing adolescent girls and young women from acquiring HIV as they grow up; and AIDS Free on providing HIV diagnosis, treatment, care and support to children and adolescents living with HIV.²
Realization of the Start Free, Stay Free and AIDS Free framework faces several barriers, including missed opportunities to test pregnant women for HIV and testing children at birth, longer HIV diagnoses for pregnant women, slower treatment initiation, lower retention in care for pregnant and breastfeeding women, viral load suppression challenges.³ Implementation science can help to address several of these barriers. We are committed to supporting implementation research focused on closing gaps that are preventing the end of paediatric AIDS.
Long-acting treatment implementation
Highly effective medications for HIV treatment exists that has improved clinical and virologic outcomes for people living with HIV and has reduced HIV acquisition for people who do not have HIV. Until recently, medications involved taking a pill or pills daily. With the development of long-acting HIV treatment, daily dosing is no longer a requirement. With the development of long-acting HIV treatment, effective implementation will be critical to ensuring optimal access for those that might benefit from this option.
Adherence and Retention in Care
Ample evidence exists that the 2025 and 2030 UNAIDS targets are attainable; early initiation of antiretroviral therapy reduces HIV morbidity and mortality and reduces incidence rates of HIV. However, to have the maximum benefits of antiretroviral therapy, it is important that people living with HIV are diagnosed early, linked to care, adhere to treatment, retained in care, and achieve and sustain virologic suppression. We are dedicated to finding innovative approaches to reach people who do not know their status and who are not being retained in care. It is also essential to identify strategies that work in supporting adherence to treatment and improving healthcare services.
- UNAIDS. Children and HIV – 2016 Fact Sheet. Available at: https://www.unaids.org/sites/default/files/media_asset/FactSheet_Children_en.pdf Last accessed: June 2020.
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Implementation Science is the study of methods to promote the integration of research findings and evidence into healthcare policy and practice.
of evidence-based interventions get into general use
of medical research dollars make a public health impact
What are the challenges of implementing HIV care?
Delivery of evidence-based interventions for HIV in service delivery settings can encounter complexities;
- Social circumstances
- Political environment
How can we help bridge the implementation gap in HIV?
Delivery of evidence-based interventions for HIV can be improved by utilising implementation strategies:
- Engaging directly with the patients
- Supporting HIV healthcare providers
- Modifying implementation dependent on context
- Working with stakeholders during implementation
How can we measure implementation success?
Implementation success can be measured using specific implementation outcomes:
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