{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:12:44Z","timestamp":1787847164546,"version":"build-2784847793"},"reference-count":45,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T00:00:00Z","timestamp":1643932800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Mexico, the number of people living with HIV (PLWH) receiving antiretroviral therapy (ART) has increased in the last 20\u00a0years. The elimination of a CD4 threshold to initiate publicly funded ART was a major policy implemented in 2014. The study objective was to assess the determinants of Virologic Failure (VF) in Mexican PLWH on first-line ART between 2008 and 2017 and to evaluate the effects of changes following the 2014 policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 10-year patient-level data analysis was conducted using the Mexican SALVAR database. The main outcome was the proportion of PLWH with VF. A multivariable logistic regression was conducted to identify the association between covariates and VF before and after the 2014 policy implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found a lower proportion of people with VF in 2014\u20132017 compared with 2008\u20132013 (50% vs 33%, p&lt;0.001). The multivariable analysis showed a reduction in the odds of virologic failure after 2014 (Odds ratio: 0.50 [95% CI: 0.48\u20130.51]). Place of treatment and level of deprivation were significant predictors of VF in during 2014\u20132017, but not before.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study indicates that, by lowering threshold levels of CD4 required for treatment initiation in Mexico, a higher number of PLWH initiated treatment during 2014\u20132017, compared to 2008\u20132013 and the odds of VF were reduced.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624211067036","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T06:54:11Z","timestamp":1643957651000},"page":"363-373","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Virologic failure in people living with HIV in 1st line ART: A 10-year Mexican population-based study"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0398-3896","authenticated-orcid":false,"given":"Amilcar","family":"Azamar-Alonso","sequence":"first","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Gilead Sciences Inc., Foster City, CA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mbuagbaw","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Biostatistics Unit, Father Sean O\u2019Sullivan Research Centre, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1305-6260","authenticated-orcid":false,"given":"Fiona","family":"Smaill","sequence":"additional","affiliation":[{"name":"ChB Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio A","family":"Bautista-Arredondo","sequence":"additional","affiliation":[{"name":"Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Eric","family":"Tarride","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada"},{"name":"The Research Institute of St Joe\u2019s Hamilton, Hamilton, ON, Canada"},{"name":"McMaster Chair in Health Technology Management Hamilton, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,2,4]]},"reference":[{"key":"bibr1-09564624211067036","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30166-2"},{"key":"bibr2-09564624211067036","volume-title":"Viral suppression for HIV treatment success and prevention of sexual transmission of HIV [Internet]","author":"WHO","year":"2018"},{"key":"bibr3-09564624211067036","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(16)30038-X"},{"key":"bibr4-09564624211067036","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix1068"},{"key":"bibr5-09564624211067036","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506816"},{"key":"bibr6-09564624211067036","volume-title":"90\u201390\u201390\u2014An ambitious treatment target to help end the AIDS epidemic [Internet]","author":"UNAIDS","year":"2014"},{"key":"bibr7-09564624211067036","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(20)30172-7"},{"key":"bibr8-09564624211067036","volume-title":"Programa de acci\u00f3n espec\u00edfico 2007-2012 en respuesta al VIH\/SIDA e ITS [Internet]","author":"CNDH","year":"2008"},{"key":"bibr9-09564624211067036","volume-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach [Internet]","author":"World Health Organization","year":"2013"},{"key":"bibr10-09564624211067036","volume-title":"Programa de Acci\u00f3n Espec\u00edfico Respuesta al VIH, Sida e ITS 2013-2018 [Internet]","author":"Secretar\u00eda de Salud","year":"2013"},{"key":"bibr11-09564624211067036","volume-title":"Centro Nacional para la Prevencion y el Control del VIH\/SIDA. 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