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Remembering individual perspectives and needs in differentiated HIV care strategies
  1. Sheree R Schwartz,
  2. Stefan Baral
  1. Key Populations Program, Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Dr Sheree R Schwartz, Key Populations Program, Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA; sschwartz{at}jhu.edu

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In 2018, the HIV pandemic response has transitioned from an emergency approach to one that will be implemented over several decades and likely for our lifetimes. An estimated 37 million people now live with HIV, of whom 21.5 million people are on antiretroviral therapy (ART) including an estimated 17.5 million people who have achieved viral suppression.1 Thus, an estimated 20 million people either require ART or improved regimens and/or adherence interventions.1 Though HIV diagnostic and prevention strategies are improving, stigma, implementation challenges and late diagnoses resulted in 1.8 million people acquiring HIV, indicating that HIV incidence has only been slowly decreasing over the last several years.1 Thus, the numbers of people requiring HIV treatment are likely to continue to increase over the coming years.

Effective support for the lifelong treatment needs of an increasing number of people living with HIV despite decreasing levels of resources requires a better understanding of the specific individual needs of people living with HIV and development of cost-effective and adaptive approaches to address these needs.2 Differentiated care models have been promoted in sub-Saharan Africa recently to address the heterogeneity in the treatment needs among people living with HIV.3 4 Men and women, old and young, pregnant and non-pregnant and individuals from urban versus rural communities may respond differently to service delivery models.5–7 Further, given that HIV transmission risks are not spread evenly across populations anywhere in the world, engagement in care and adherence challenges are likely to differ across populations as well. …

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