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Large and safe or small and cheap? It pays off to compare before you book. Here you can compare rental cars and vehicle rent from several companies at Salerno Costa d'Amalfi Airport in Salerno, Italy. Closest communities are Bellizzi 3 km, Pontecagnano 4 km, Battipaglia 6 km, Montecorvino Pugliano 7 km and Montecorvino Rovella 10 km. Autoitaly.co.uk lists prices from companies that are safe and quality assured so that there will be no problems when you want to pick your car up. Airport code is IATA: QSR and ICAO: LIRI.
We have easy and safe online booking for rental cars. Look for rental cars that you can pick up at Salerno Costa d'Amalfi Airport. In the search box you can search for the location you want and choose from the list. Car hire, where every cost is included, no hidden fees and free cancellations/amendments up to 24 hours before you are supposed to pick up the car. Collect the car in one place and return it somewhere else, e.g. another city or country. It is possible to rent a car for one way, called the one way rental. Compare the number of days you want, whether that be a week, weekend, rent for a day, a year, a whole month or a long-term rental. Hertz on Via Olmo Bellizzi are the companies we compare at the airport to find the best price. 7 seat minivan, cargo van, moped, fullsize, premium, intermediate, estate, 5 seat minivan, standard, 9 seat minivan, minibus, luxury, convertible, economy, mini, minivan, suv, jeep, compact and automatic transmission cars are car types and models that autoitaly.co.uk can compare prices on.
Information, facts and data about Salerno Costa d'Amalfi Airport (Salerno-Pontecagnano Airport). In the municipality of Provincia di Salerno, in the Campania region, in Italy. The airport is located about 123 feet/37 meters above sea level. Salerno Costa d'Amalfi Airport, Salerno Amalfi Coast – Costa d'Amalfi Airport, Aeroporto Salerno Costa d'Amalfi, Salerno-Pontecagnano Airport, International are other names for this airport. Naples Airport are nearby airports. Naples 60 km (c. 959500 pop), Salerno 12 km (c. 125800 pop), Torre del Greco 49 km (c. 85900 pop), Giugliano in Campania 69 km (c. 80300 pop), Caserta 70 km (c. 72800 pop) and Castellammare di Stabia 37 km (c. 65700 pop) are big cities and municipalities nearby. Tax-free shopping? In the airport and nearby are e.g. Siniscalchi Centro Commerciale and Maximall. They are only a walk from the terminal. Are you planning to, or flying to/from, and will be using Salerno Costa d'Amalfi Airport on your holiday or trip? Here you can find information, maps, weather, contact information and airport information. More information on where to you pick up or return your rental car, will be given after your reservation has been made. All companies have their own offices where you can pick up keys etc. Need a place to sleep? Hotel Carosello, Hotel Club Sabbiadoro, Hotel Olimpico, Hotel Congressi San Luca and La Isla Resort are examples of hotels and youth hostels close to the airport. They are all within 3 km. If you come to the airport, or will continue by train when you have left or picked up the rental car, Pontecagnano, Stazione Ferroviaria di Battipaglia and Stadio Arechi are nearby.
Car hire companies and car rental at Salerno Amalfi Coast Pontecagnano Airport (QSR), Italy
Hertz, Keddy By Europcar, Viten Group, Ace Rental Cars, Alamo, Europcar, Buchbinder, Welcome Cars, B-Rent, Green Motion, Target Rent, Elba by Car, Sicily By Car, Goldcar, Optimorent, CarMotion, Ecovia, Global Rent a Car, Thrifty, Italy Car Rent, Noleggiare, Locauto, Nomadcar, OS Car Rental, MoriniRent, Smile Rent, Surprice, Payless, Avant Car, Autovia, Dollar, Avis, InterRent, Centauro, Firefly, Budget, Hertz Dream Collection, WinRent, King rent, JoyRent, National, Sixt, Rhodium, Maggiore, Enterprise, Flizzr, Oscar Rent A Car and Autoclick are the companies we compare at the airport to find the best price.


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The Lamb in the Roses Quilt Pattern
The perfect quilt for your perfect baby!
A garden full of roses, a warm dresden plate sun and one irresistibly cute lamb combine to make this the perfect way to welcome your newest little one into the world. Shown here in floral, this baby quilt could also be easily completed using solids or pastels for a more gender neutral quilt. Full size, printable applique patterns are included. Quilt is constructed using a combination of machine & raw edge applique. Finished size; 37" x 46".
Customers Also Purchased
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- Telephone:
- 07779 889983
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Click 'compare' to add up to 3 vehicles to compare against their specifications.Compare now
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Finance calculator
Finance examples for HP and PCP will be returned if available, based on the above parameters. Finance subject to status.
There are 51 used cars available matching your search.
Chrysler PT Cruiser 2.2 CRD Touring Hatchback 5dr Diesel Manual (185 g/km, 119 bhp)
31 Photos
- 2005 (54) reg
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Car is in very condition for Age & Mileage, Car will be sold with PDI / Serviced & Warranty supplied on screen price, Finance Options & Extended Warranty available on Request, Viewing Essential!, , **...
Representative example
- 201906068740958
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Type Duration of agreement First payment monthly payments Final payment
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2214 35TH ST - Allegan MI 49010Be the first to review this business
Allegan, MI 49010
Phone: 616-393-****616-393-936515 (click to view the number)
About the Company
Fantastic cities to be a home-owner are Allegan, Hopkins, Otsego and Kendall. Any carpet problems must not be things our clients must worry about. Just what does Regional Carpet Cleaning focus on? Our company's area of expertise: carpet upgrading, upgrading of home rugs, commercial carpeting upgrading and engineering of residential carpets and tiles. A lot of experienced Allegan, MI carpet providers are super easy to get a hold of, so deciding on the right provider may be a difficult choice. "Regional Carpet Cleaning will get it completed when they're due" is our company's philosophy.
Additional Information
|Services Offered:
Carpet Carpet Cleaning Cleaning
|Are we a residential contractor?
|Are we a commercial contractor?
|Do we offer financing?
|Do we have emergency service?
|Do we accept credit cards?
Additional Company Information
Regional Carpet Cleaning - Carpet Installers in Allegan, Michigan.
Hours Please call to confirm
|8:00am - 6:00pm
|8:00am - 6:00pm
|8:00am - 6:00pm
|8:00am - 6:00pm
|8:00am - 6:00pm
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About eHARDHAT
eHARDHAT helps homeowners find great contractors for home improvement projects.
To get started, browse the best Allegan Carpet Installers, read reviews, find detailed contractor information on individual Carpet Installers in Allegan and request free project estimates.
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Finding accurate service costs before planning a remodeling project is important for keeping the overall project costs down. Are you looking to install carpeting in Allegan soon? Find accurate Allegan carpet installation costs right now.
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We work hard to help you make confident decisions regarding which home products and services to purchase, as well as help you identify trustworthy local Allegan carpet installation contractors. Our goal is to make sure you are able to have quality work completed at a fair price and on time.
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Statistics and meaning of name Shahzaib
Usage: 88% firstname, 12% surname.
Shahzaib first name was found 272 times in 11 different countries.
Surname Shahzaib is used at least 37 times in at least 5 countries.
Origin of this name is Urdu.
Gender of firstname Shahzaib is 0% feminine and 100% masculine.
Given names
Zeeshan Shahzaib (1)
Wajid Shahzaib (1)
Syed Shahzaib (1)
Shahzaib Shahzaib (1)
Mohammed Shahzaib (1)
Family names
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Shahzaib Khalid (1)
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Shahzaib Keerio (1)
Shahzaib reversed is Biazhahs
Name contains 8 letters - 37.50% vowels and 62.50% consonants.
Anagrams: Haaszibh Ihsahabz
Misspells: Shohzaib Sshahzaib Shahzayb Shahzajb Shahzaeb Shahzaiba Sahhzaib Shahzabi Shahziab
Rhymes: sulfate sulphate
Meaning of name Shahzaib is: Crown of a king, like a king
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Client Services Planner
Permanent Full-time
Redlynch Cairns QLD 4870
Are you looking for an exciting career that will give you plenty of opportunities to grow and develop?
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Revolutionizing healthcare staffing by making it simple and affordable to hire per diem or temporary team members.
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Will travel 20 miles
$40 per hour.
5.0 27 ratings
With five years of tutoring experience in math and sciences, I am ready to help students on any math courses from algebra to multivariable calculus. I received 5 on AP Calculus BC and took several advanced mathematical courses at Cornell University. My name is Joseph. I graduated Magna Cum Laude from Cornell University with a degree in Physics. I first became interested in tutoring when I moved to America. I was lost without knowing the language or the culture, but my neighbor volunteered his time to tutor me English three times a week and show me around the neighborhood. His altruism and dedi [more]
Will travel 20 miles
$100 per hour.
4.91 128 ratings
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Will travel 10 miles
$60 per hour.
5.0 26 ratings
During my teaching career I taught AP Calculus AB & BC as well as advanced courses such as Finite Mathematics and Matrix Theory. I enjoy theory as much as applications, and can help students become more proficient in applying graphing calculators (particularly TI-84 and TI-89). After a rewarding teaching career in independent college preparatory schools, I retired in June 2014 to focus on tutoring individuals. Over the years I have enjoyed the opportunity to present graphing calculator workshops at mathematics and education conferences including the Teachers Teaching with Technology Internatio [more]
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$150 per hour.
5.0 25 ratings
As a Wellesley College student cross-registered at MIT in biological and chemical engineering, I earned a dual B.A. degree in humanities and biochemistry, the latter of which is certified with distinction from the American Society for Biochemistry and Molecular Biology. I have completed coursework in advanced mathematics and have tutored mathematics for more than a decade, including calculus. I have tutored all levels, from grade school to college. In particular, high school and college students with whom I have worked have significantly improved their test scores and class grades. I have a bl [more]
Will travel 10 miles
$60 per hour.
0.0 0 ratings
My goal of tutoring is to help my students build up practical problem solving skills that they could use to boost their school grades, through systematic approach and smart work. I am an engineer with a bachelor?s degree as well as two master?s degrees in engineering. Formal training in engineering fields at both college and graduate schools built up a solid foundation for my strong analytical skills. I loved to play with numbers even before I was old enough to start school. During colleg... [more]
Will travel 40 miles
$125 per hour.
4.99 92 ratings
Andrew studied the basic and social sciences, searching for answers to some of life's biggest questions, including the role of nutrition in human health, the basis for human decision-making, and how to win in Monopoly. He earned a B.A. in the Biological Sciences at the University of Chicago, graduated from Georgetown University with an M.S. in Physiology and Biophysics, and earned his M.D. from the Virginia Tech Carilion School of Medicine. His tutoring career began in 2010 when he signed on ... [more]
Will travel 10 miles
$40 per hour.
5.0 3 ratings
Calculus is a set of tools that offer a sophisticated approach to determining areas, volumes, and rates of change. I have taken 5 semesters of calculus in total; calculus 1, 2, and 3, differential equations, and mathematical physics. Limits, differentiation, and integration are a few concepts from calculus that I applied in my physical chemistry, electromagnetic theory, and quantum mechanics coursework. Hi there, my name is James and I'm excited to help you learn. I recently graduated from SUNY Potsdam where I studied Chemistry and Physics. I find the study of chemistry, and the physics that [more]


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So, Are you Searching for Steroids in Dominican Republic? Why Not to Buy Online from This Website?
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The Willis Retreat - Fairplay Cabin on 8 Secluded Acres, Hot Tub, Pet Friendly!
- Cabin2300 sq. ft.
- Sleeps: 6
- Bedrooms: 4
- Bathrooms: 2
- Min Stay: 5 nights
Cabin, 4 Bedrooms + Convertible bed(s), 2 Baths
Randy Willis
- Languages:
- english
About Randy Willis
We are life-long Colorado residents, we love spending time in the mountains with our 2 kids and 2 dogs, and we are truly blessed to be able to share this wonderful property with others.
Randy Willis purchased this Cabin in 2002
Why Randy Willis chose Fairplay
We chose this area for a number of reasons. First, its a quick 90 minute drive from where we live in Denver, and you don't have to deal with the traffic gridlock on I-70! Second, its much less crowded than a lot of the tourist areas in the Mountains yet all the necessities are within 5 minutes of the cabin. We didn't want a property in a busy resort community but we did want to be near one. This area fit the bill because its just 20 miles to Breckenridge. And finally, its an absolutely gorgeous area throughout the year.
What makes this Cabin unique
My favorite thing about the Willis Retreat is its location. While its only 5 minutes from town it is absolutely peaceful and secluded. There are other cabins in our area but you cannot see them so the privacy is wonderful. The upstairs patio is huge and is a great place to enjoy a beverage while overlooking a pretty meadow with South Park and the Mosquito Range in the background. Our kids love the treehouse in the backyard and the sledding hills in the Winter. Within just a few minutes of the cabin there are great hiking and 4-wheel drive trails, and if you like fishing there are tons of streams and lakes full of trout. Finally, at the end of a long day there's nothing like relaxing and unwinding in the hot tub. To me, this is the Rocky Mountains at its best.
- Children Welcome
- Washer & Dryer
- Satellite or Cable
- Internet
- Heater
- Pets Welcome
- Parking
- Fireplace
- Hot Tub
- 2 Bathrooms
House Rules
Please consider the following guidelines when booking this property:
Cancellation Policy
100% refund if canceled at least 30 days before arrival date. 50% refund if canceled at least 14 days before arrival date.
153 Reviews
Great location, spacious
The cabin is a very, very short drive to HWY 9, making it easily accessible to downtown Fairplay, Alma, and Breckenridge. The cabin is spacious, cozy. Make sure you have an AWD or 4 x 4 vehicle, if youre going during the winter months! We really enjoyed our stay, was hard to leave.
An amazing cabin with a fantastic owner to work with
This was our fourth time visiting the Willis Retreat, and each time has been perfect. The cabin itself is always clean, and feels like home. We keep coming back for the clean hot tub with an excellent view into the back yard. We keep coming back for the rustic styling and home like feel to it. But most importantly we keep coming back because Randy is such an awesome and easy person to work with.
We have basically made this a yearly tradition, and I don't see any reason that will change!
Christmas at Willis Retreat Dec 18
Outstanding stay at the Willis Retreat; Christmas ski trip for family of four. Very comfortable and clean; large and well stocked kitchen supported all our needs; comfortable bedrooms and 2 bathrooms perfect for our family; enjoyed the hot tub each evening after a full day of skiing. Nice, quiet location and great views. Randy provided plenty of information to support our stay and was very responsive to any questions. We highly recommend the Willis Retreat.
Great Stay!
Everything was as advertised. A very clean, comfortable and well stocked cabin. I would definitely go back!
Happy 61st Birthday For My Wife Susan
I planned a surprise 61st birthday 18 day motorcycle trip for my wife and I. The Willis Retreat was the very first property I reviewed and fell in love with it by the description and the pictures. It exceeded all expectations and made for a special week of our trip. Just outstanding!!! Thanks Randy for all the information prior to our trip!
Quiet and Comfortable Retreat
My family and I really enjoyed our stay at the Willis Retreat. The cabin was very comfortable and equipped with everything we needed to relax and have fun. My son and husband had a great time in "the game room" with the PlayStation gaming system. It served as a great home base for local activities. Fairplay is very close and Alma is only a few minutes away where we found everything we needed to grill outside and prepare meals in a very accommodating kitchen. We attended the Burro Days festivities in Fairplay which was great fun and I highly recommend this to families. We found some great hikes in the area and visited Brekenridge a few times which is a relatively short and beautiful drive. Overall, the vacation was very enjoyable and we look forward to returning to The Willis Retreat for another relaxing and fun time.
The South Park Recreation Center is 5 minutes from the cabin with full workout facilities, indoor swimming pool, and other amenities.


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Food safety tips for the summer
JAMAICANS really don't need to wait for summer to have a party or gathering, but the season is here and the party temperature is definitely rising — along with the sizzling heat, of course.
This means the colourful umbrellas, backyard furniture and grills will be making their way into the outdoors, picnic areas and beaches filled with friends and family, pooling together for a great, big potluck feast.
However, there is always that one nagging possibility that can ruin a rambunctious feast, and that is some food-borne disease that can emerge due to unsafe handling of the tons of fresh produce, fish, chicken, and other meat items.
Food safety is always on the front burner and as recently as April 19, the US Department of Agriculture's Food Safety and Inspection service announced a recall of more than 62,000 pounds of raw beef produced by the Aurora Packing Company in North Aurora, Illinois, that may have been contaminated with the food-borne disease, E coli. Among the recalled beef products were brisket, short ribs, and ribeye steaks.
The heat of summer makes it imperative for us to be vigilant about food safety during these gatherings, especially when the preparation of food is coming from all quarters. As no one wants to miss out on a great feast by people getting sick, here are some tips to keep in mind while cutting up fresh fruits and vegetables, or lighting up the grill for those mouth-watering burgers and other meat products.
Thoroughly washing produce is definitely high on the food safety agenda. Think of how many hands touch fruits and vegetables before they reach our supermarkets and farmers' markets, and the myriad opportunities for contamination, including residue from pesticides. Among the list are the growers, the pickers, the packers, the mode of transportation, and of course, those who rummage through them to make their selection before purchasing.
Washing hands with soap and warm water before and after handling fresh produce is also a key point. A colleague of mine, Helen Kennedy, associate consultant with Technological Solutions Limited, gave this fun tip during a training session: "Sing the happy birthday song at least twice while washing your hands, and by the time you are done, your hands should be squeaky clean."
To keep produce safe, follow these tips:
• Store perishable produce in the refrigerator.
• Wash produce before peeling and cutting to prevent contaminants being transferred from your knife to the fruit or vegetable.
• Hold the fruit or vegetable under cool running tap water, gently rubbing it as you rinse it.
• Use a clean cloth or paper towel to dry the produce before using or serving.
Grill smart
Most people eat with their eyes at first, and that grill mark across burgers, corn on the cob, hot dogs and pizzas, can really get the digestive juices going. However, there are some safety tips to remember:
• Avoid thawing meat at room temperature, but preferably overnight in the refrigerator on a plate or in a pan to catch any juices.
• Don't take meat out of the refrigerator until you're ready to grill.
• Always have clean plates and utensils to place cooked food on to prevent cross-contamination with serving pieces on which the raw meat was placed.
Plan a safe potluck
Follow these tips at your picnic, potluck, barbecue, or garden party:
• Never serve food that's been out of the refrigerator, off the stove or grill, or out of the oven longer than two hours.
• Make side dishes that don't need refrigeration and avoid sides like salads containing ingredients that need refrigeration.
• Keep cold foods on ice. Set your serving bowl inside a larger bowl filled with ice.
• Keep hot foods hot by serving in chafing dishes, ensuring that the chafing fuel is always lit.
• Keep food and beverages in separate coolers to avoid picnickers digging for a drink, opening and closing the cooler with food in it.
Dr Wendy-Gaye Thomas is group technical manager, Technological Solutions Limited, a Jamaican food technology company. Email her at email@example.com


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General health and self-efficacy for health practices of pregnant women: is it important for motherhood?
This study aimed to investigate the relationship between general health and self-efficacy for health practices of pregnant women.
Subjects and methods
In this descriptive cross-sectional study, a two-stage cluster-sampling method was applied and 300 pregnant women were selected from 15 health centers affiliated with a large medical university in the southeast of Iran. Data were collected using a demographic questionnaire, the General Health Questionnaire (GHQ-28), and the Self Rated Abilities for Health Practices Scale (SRAHPS).
The pregnant women's total mean score for the GHQ-28 was 28.65 ± 10.92, which showed slight general health disorders. The total mean score of participants' self-efficacy for health practices was moderate (54.47 ± 18.40). A significant relationship was observed between general health and self-efficacy for health practices (r = − 0.35, p = 0.01).
Pregnant women had slight general health disorders and moderate self-efficacy for health practices. According to the findings, increasing general health status of pregnant women improved their self-efficacy for health practices. Therefore, general health-promoting interventions are recommended to improve self-efficacy for health practices of pregnant women.
KeywordsMental health Self-efficacy Health practices Health-promotion behaviors Pregnancy
The researchers would like to appreciate the pregnant women who devoted so graciously a part of their time to participate in the study.
Author contributions
All researchers contributed to designing and drafting this research. All authors contributed equally to writing the manuscript. All authors reviewed and approved the final manuscript.
Compliance with ethical standards
The Ethics Committee affiliated to Kerman University of Medical Sciences approved this study with the code of Ir.kmu.rec.1395.92. In order to observe the ethical considerations, the researcher initially presented the letter of introduction and made the required coordination with the health centers. Then, verbal agreement of participants was obtained and they were assured about confidentiality and anonymity of the data. Women were also assured about voluntary participation in the study. Informed consent forms were also received from the participants.
Conflict of interest
The authors declare that they have no competing interests.
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The HIV prevention cascade: more smoke than thunder?
Lancet. HIV. 2016 Jul; 3(7):e286-8.Add to my documents.
The impact and cost of ending AIDS in Botswana.
Lancet. HIV. 2016 Sep; 3(9):e409.Add to my documents.
Pre-exposure prophylaxis (PrEP) in an era of stalled HIV prevention: Can it change the game?
Retrovirology. 2018 Apr 2; 15(1):29.Pre-exposure prophylaxis (PrEP) for HIV prevention has evolved significantly over the years where clinical trials have now demonstrated the efficacy of oral PrEP, and the field is scaling-up implementation. The WHO and UNAIDS have made PrEP implementation a priority for populations at highest risk, and several countries have developed guidelines and national plans accordingly, largely based on evidence generated by demonstration projects. PrEP presents the opportunity to change the face of HIV prevention by offering a new option for protection against HIV and disrupting current HIV prevention systems. Nevertheless, as with all new technologies, both practical and social requirements for implementation must be taken into account if there is to be sustained and widespread adoption, which will also apply to forthcoming prevention technologies. Defining and building success for PrEP within the scope of scale-up requires careful consideration. This review summarises where the PrEP field is today, lessons learned from the past, the philosophy and practicalities of how successful programming may be defined, and provides perspectives of costs and affordability. We argue that a successful PrEP programme is about effective intervention integration and ultimately keeping people HIV negative.
Application opportunities of geographic information systems analysis to support achievement of the UNAIDS 90-90-90 targets in South Africa.
South African Medical Journal. 2017 Nov 27; 107(12):1065-1071.In an effort to achieve control of the HIV epidemic, 90-90-90 targets have been proposed whereby 90% of the HIV-infected population should know their status, 90% of those diagnosed should be receiving antiretroviral therapy, and 90% of those on treatment should be virologically suppressed. In this article we present approaches for using relatively simple geographic information systems (GIS) analyses of routinely available data to support HIV programme management towards achieving the 90-90-90 targets, with a focus on South Africa (SA) and other high-prevalence settings in low- and middle-income countries. We present programme-level GIS applications to map aggregated health data and individual-level applications to track distinct patients. We illustrate these applications using data from City of Johannesburg Region D, demonstrating that GIS has great potential to guide HIV programme operations and assist in achieving the 90-90-90 targets in SA.
A Decade of Monitoring HIV Epidemics in Nigeria: Positioning for Post-2015 Agenda.
AIDS and Behavior. 2017 Jul; 21(Suppl 1):62-71.BACKGROUND: Nigeria accounts for 9% of the global HIV burden and is a signatory to Millennium Development Goals as well as the post-2015 Sustainable Development Goals. This paper reviews maturation of her HIV M&E system and preparedness for monitoring of the post-2015 agenda. METHODS: Using the UNAIDS criteria for assessing a functional M&E system, a mixed-methods approach of desk review and expert consultations, was employed. RESULTS: Following adoption of a multi-sectoral M&E system, Nigeria experienced improved HIV coordination at the National and State levels, capacity building for epidemic appraisals, spectrum estimation and routine data quality assessments. National data and systems audit processes were instituted which informed harmonization of tools and indicators. The M&E achievements of the HIV response enhanced performance of the National Health Management Information System (NHMIS) using DHIS2 platform following its re-introduction by the Federal Ministry of Health, and also enabled decentralization of data management to the periphery. CONCLUSION: A decade of implementing National HIV M&E framework in Nigeria and the recent adoption of the DHIS2 provides a strong base for monitoring the Post 2015 agenda. There is however a need to strengthen inter-sectoral data linkages and reduce the rising burden of data collection at the global level.
The continuum of HIV care in South Africa: implications for achieving the second and third UNAIDS 90-90-90 targets.
AIDS. 2017 Feb 20; 31(4):545-552.BACKGROUND: We characterize engagement with HIV care in South Africa in 2012 to identify areas for improvement towards achieving global 90-90-90 targets. METHODS: Over 3.9 million CD4 cell count and 2.7 million viral load measurements reported in 2012 in the public sector were extracted from the national laboratory electronic database. The number of persons living with HIV (PLHIV), number and proportion in HIV care, on antiretroviral therapy (ART) and with viral suppression (viral load <400 copies/ml) were estimated and stratified by sex and age group. Modified Poisson regression approach was used to examine associations between sex, age group and viral suppression among persons on ART. RESULTS: We estimate that among 6511 000 PLHIV in South Africa in 2012, 3300 000 individuals (50.7%) accessed care and 32.9% received ART. Although viral suppression was 73.7% among the treated population in 2012, the overall percentage of persons with viral suppression among all PLHIV was 23.8%. Linkage to HIV care was lower among men (38.5%) than among women (57.2%). Overall, 47.1% of those aged 0-14 years and 47.0% of those aged 15-49 years were linked to care compared with 56.2% among those aged above 50 years. CONCLUSION: Around a quarter of all PLHIV have achieved viral suppression in South Africa. Men and younger persons have poorer linkage to HIV care. Expanding HIV testing, strengthening prompt linkage to care and further expansion of ART are needed for South Africa to reach the 90-90-90 target. Focus on these areas will reduce the transmission of new HIV infections and mortality in the general population.
National responses to global health targets: exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda.
Health Policy and Planning. 2018 Jan 1; 33(1):17-33.Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, program and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Program on HIV/AIDS set 'ambitious' treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by program, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to '90-90-90'. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in program-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analyzed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh's policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of program activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation, facilitating a shift in the HIV program from 'business as usual' to approaches targeting geographies and populations.
Harm reduction saves lives.
Geneva, Switzerland, UNAIDS, 2017. 12 p.People who use and inject drugs are among the groups at highest risk of exposure to HIV, but remain marginalized and out of reach of health and social services.
Male engagement in the HIV response — a platform for action.
Geneva, Switzerland, UNAIDS, 2016. 12 p.Gender inequalities and harmful gender norms are important drivers of the HIV epidemic, and they are major hindrances to an effective HIV response. While access to HIV services for women and girls remain a concern, a growing body of evidence also shows that men and adolescent boys have limited access to HIV services. Current effort to advance both gender equality and sexual and reproductive health and rights as key elements of the HIV response do not adequately reflect the ways that harmful gender norms and practices negatively affect men, women and adolescent body and girls in all their diversity. This in turn increases HIV-related vulnerability and risk among all of these groups.
Ending AIDS: Progress towards the 90-90-90 targets. Global AIDS update -- 2017.
Geneva, Switzerland, UNAIDS, 2017. 198 p. (UNAIDS/JC2900E)Since they were launched at the 20th International AIDS Conference in Melbourne, Australia, in 2014, the 90-90-90 targets have become a central pillar of the global quest to end the AIDS epidemic. The targets reflect a fundamental shift in the world's approach to HIV treatment, moving it away from a focus on the number of people accessing antiretroviral therapy and towards the importance of maximising viral suppression among people living with HIV. This shift was driven by greater understanding of the benefits of viral suppression -- not only does treatment protect people living with HIV from AIDS-related illness, but it also greatly lowers the risk of transmitting the virus to others.
Population-level impact of an accelerated HIV response plan to reach the UNAIDS 90-90-90 target in Cote d'Ivoire: Insights from mathematical modeling.
PLoS Medicine. 2017 Jun; 14(6):e1002321.BACKGROUND: National responses will need to be markedly accelerated to achieve the ambitious target of the Joint United Nations Programme on HIV/AIDS (UNAIDS). This target aims for 90% of HIV-positive individuals to be aware of their status, for 90% of those aware to receive antiretroviral therapy (ART), and for 90% of those on treatment to have a suppressed viral load by 2020, with each individual target reaching 95% by 2030. We aimed to estimate the impact of various treatment-as-prevention scenarios in Cote d'Ivoire, one of the countries with the highest HIV incidence in West Africa, with unmet HIV prevention and treatment needs, and where key populations are important to the broader HIV epidemic. METHODS AND FINDINGS: An age-stratified dynamic model was developed and calibrated to epidemiological and programmatic data using a Bayesian framework. The model represents sexual and vertical HIV transmission in the general population, female sex workers (FSW), and men who have sex with men (MSM). We estimated the impact of scaling up interventions to reach the UNAIDS targets, as well as the impact of 8 other scenarios, on HIV transmission in adults and children, compared to our baseline scenario that maintains 2015 rates of testing, ART initiation, ART discontinuation, treatment failure, and levels of condom use. In 2015, we estimated that 52% (95% credible intervals: 46%-58%) of HIV-positive individuals were aware of their status, 72% (57%-82%) of those aware were on ART, and 77% (74%-79%) of those on ART were virologically suppressed. Reaching the UNAIDS targets on time would avert 50% (42%-60%) of new HIV infections over 2015-2030 compared to 30% (25%-36%) if the 90-90-90 target is reached in 2025. Attaining the UNAIDS targets in FSW, their clients, and MSM (but not in the rest of the population) would avert a similar fraction of new infections (30%; 21%-39%). A 25-percentage-point drop in condom use from the 2015 levels among FSW and MSM would reduce the impact of reaching the UNAIDS targets, with 38% (26%-51%) of infections averted. The study's main limitation is that homogenous spatial coverage of interventions was assumed, and future lines of inquiry should examine how geographical prioritization could affect HIV transmission. CONCLUSIONS: Maximizing the impact of the UNAIDS targets will require rapid scale-up of interventions, particularly testing, ART initiation, and limiting ART discontinuation. Reaching clients of FSW, as well as key populations, can efficiently reduce transmission. Sustaining the high condom-use levels among key populations should remain an important prevention pillar.
Projected Uptake of New Antiretroviral (ARV) Medicines in Adults in Low- and Middle-Income Countries: A Forecast Analysis 2015-2025.
PloS One. 2016; 11(10):e0164619.With anti-retroviral treatment (ART) scale-up set to continue over the next few years it is of key importance that manufacturers and planners in low- and middle-income countries (LMICs) hardest hit by the HIV/AIDS pandemic are able to anticipate and respond to future changes to treatment regimens, generics pipeline and demand, in order to secure continued access to all ARV medicines required. We did a forecast analysis, using secondary WHO and UNAIDS data sources, to estimate the number of people living with HIV (PLHIV) and the market share and demand for a range of new and existing ARV drugs in LMICs up to 2025. UNAIDS estimates 24.7 million person-years of ART in 2020 and 28.5 million person-years of ART in 2025 (24.3 million on first-line treatment, 3.5 million on second-line treatment, and 0.6 million on third-line treatment). Our analysis showed that TAF and DTG will be major players in the ART regimen by 2025, with 8 million and 15 million patients using these ARVs respectively. However, as safety and efficacy of dolutegravir (DTG) and tenofovir alafenamide (TAF) during pregnancy and among TB/HIV co-infected patients using rifampicin is still under debate, and ART scale-up is predicted to increase considerably, there also remains a clear need for continuous supplies of existing ARVs including TDF and EFV, which 16 million and 10 million patients-respectively-are predicted to be using in 2025. It will be important to ensure that the existing capacities of generics manufacturers, which are geared towards ARVs of higher doses (such as TDF 300mg and EFV 600mg), will not be adversely impacted due to the introduction of lower dose ARVs such as TAF 25mg and DTG 50mg. With increased access to viral load testing, more patients would be using protease inhibitors containing regimens in second-line, with 1 million patients on LPV/r and 2.3 million on ATV/r by 2025. However, it will remain important to continue monitoring the evolution of ARV market in LMICs to guarantee the availability of these medicines.
Global standards for quality health care services for adolescents. A guide to implement a standards-driven approach to improve the quality of health-care services for adolescents. Volume 4: Scoring sheets for data analysis.
Geneva, Switzerland, World Health Organization, 2015. 132 p.Global initiatives are urging countries to prioritize quality as a way of reinforcing human rights-based approaches to health. Yet evidence from both high- and low-income countries shows that services for adolescents are highly fragmented, poorly coordinated and uneven in quality. Pockets of excellent practice exist, but, overall, services need significant improvement and should be brought into conformity with existing guidelines. The aim of Global standards for quality health-care services for adolescents is to assist policy-makers and health service planners in improving the quality of health-care services so that adolescents find it easier to obtain the health services that they need to promote, protect and improve their health and well-being. This volume is to be used in conjunction with the monitoring tools in Volume 3. Using this data analysis method, countries can determine compliance with quality standards. How to use this volume: The scoring sheets in this volume are organized by criterion. There is a separate scoring sheet for each criterion. The total scores for all the criteria that apply to a standard are averaged to yield an overall score for that standard.
Global standards for quality health care services for adolescents. A guide to implement a standards-driven approach to improve the quality of health-care services for adolescents. Volume 3: Tools to conduct quality and coverage measurement surveys to collect data about compliance with the global standards.
Geneva, Switzerland, World Health Organization, 2015. 100 p.Global initiatives are urging countries to prioritize quality as a way of reinforcing human rights-based approaches to health. Yet evidence from both high- and low-income countries shows that services for adolescents are highly fragmented, poorly coordinated and uneven in quality. Pockets of excellent practice exist, but, overall, services need significant improvement and should be brought into conformity with existing guidelines. The aim of Global standards for quality health-care services for adolescents is to assist policy-makers and health service planners in improving the quality of health-care services so that adolescents find it easier to obtain the health services that they need to promote, protect and improve their health and well-being. This volume includes tools to determine whether the implementation of the standards has been achieved. These tools can be adapted for use in different contexts -be it self-assessments on a limited number of criteria, or external assessments (monitoring visits) by district managers, on a wider, or full range, of standards and criteria. The tools can be equally adapted to develop checklists for supportive supervision. The toolkit included in this volume contains seven tools to collect data about quality of care (as measured by the criteria of the standards) and two tools to gather information about coverage.
Global standards for quality health care services for adolescents. A guide to implement a standards-driven approach to improve the quality of health-care services for adolescents. Volume 2: Implementation guide.
Geneva, Switzerland, World Health Organization, 2015. 28 p.Global initiatives are urging countries to prioritize quality as a way of reinforcing human rights-based approaches to health. Yet evidence from both high- and low-income countries shows that services for adolescents are highly fragmented, poorly coordinated and uneven in quality. Pockets of excellent practice exist, but, overall, services need significant improvement and should be brought into conformity with existing guidelines. The aim of Global standards for quality health-care services for adolescents is to assist policy-makers and health service planners in improving the quality of health-care services so that adolescents find it easier to obtain the health services that they need to promote, protect and improve their health and well-being. This volume, the Implementation guide, provides detailed guidance on identifying what actions need to be taken to implement the standards at the national, district and facility levels. It can be used to develop checklists to assess the status of implementation.
Global standards for quality health care services for adolescents. A guide to implement a standards-driven approach to improve the quality of health-care services for adolescents. Volume 1: Standards and criteria.
Geneva, Switzerland, World Health Organization, 2015 40 p.Global initiatives are urging countries to prioritize quality as a way of reinforcing human rights-based approaches to health. Yet evidence from both high- and low-income countries shows that services for adolescents are highly fragmented, poorly coordinated and uneven in quality. Pockets of excellent practice exist, but, overall, services need significant improvement and should be brought into conformity with existing guidelines. The aim of Global standards for quality health-care services for adolescents is to assist policy-makers and health service planners in improving the quality of health-care services so that adolescents find it easier to obtain the health services that they need to promote, protect and improve their health and well-being. The implementation plan and the monitoring tools that accompany the standards in this document provide guidance on identifying what actions need to be taken to implement the standards and to assess whether the standards have been achieved. The primary intention of the standards is to improve the quality of care for adolescents in government healthcare services; however, they are equally applicable to facilities run by NGOs and those in the private sector. The ultimate purpose of implementing the standards is to increase adolescents' use of services and, thus, to contribute to better health outcomes.
A tool for strengthening gender-sensitive national HIV and Sexual and Reproductive Health (SRH) monitoring and evaluation systems.
Geneva, Switzerland, WHO, 2016. 126 p.WHO and UNAIDS have released a new tool for strengthening gender-sensitive national HIV and sexual and reproductive health (SRH) monitoring and evaluation systems. The tool provides step-by-step guidance to strategic information specialists and monitoring and evaluation officers of HIV and SRH programmes on how to ask the right questions in order to uncover gender inequalities and their influence on health; identify and select gender-sensitive indicators; conduct gender-analysis of SRH and HIV data; and strengthen monitoring and evaluation systems to enable appropriate data collection and gender analysis. The tool has been used by nearly 30 country teams of strategic information specialists, civil society and HIV programme implementers to analyse their own SRH and HIV data from a gender equality perspective. It can be used for training monitoring and evaluation specialists as well as a resource guide for SRH and HIV programmes to develop gender profiles of their SRH and HIV situation. "Know your epidemic, know your response" has been the cornerstone of the HIV response. This tool supports this approach by helping identify inequities and underlying drivers and hence, improve evidence-informed SRH and HIV programmes for all, but particularly for women and girls.
Get on the fast-track. The life-cycle approach to HIV. Finding solutions for everyone at every stage of life.
Geneva, Switzerland, UNAIDS, 2016. 140 p.In this report, UNAIDS is announcing that 18.2 million people now have access to HIV treatment. The Fast-Track response is working. Increasing treatment coverage is reducing AIDS-related deaths among adults and children. But the life-cycle approach has to include more than just treatment. Tuberculosis (TB) remains among the commonest causes of illness and death among people living with HIV of all ages, causing about one third of AIDS-related deaths in 2015. These deaths could and should have been prevented. TB, like cervical cancer, hepatitis C and other major causes of illness and death among people living with HIV, is not always detected in HIV services. It is vital that we collaborate closely with other health programmes to prevent unnecessary deaths. The impact of better treatment coverage means that a growing number of people will be living with HIV into old age, while there has also been an increase in new HIV infections among older people. The consequences of long-term antiretroviral therapy, combined with the diseases of ageing, will be new territory for many HIV programmes. Drug resistance is a major threat to the AIDS response, not just for antiretroviral medicines but also for the antibiotic and antituberculous medicines that people living with HIV frequently need to remain healthy. More people than ever before are in need of second- and third-line medicines for HIV and TB. The human burden of drug resistance is already unacceptable; the financial costs will soon be unsustainable. We need to make sure the medicines we have today are put to best use, and accelerate and expand the search for new treatments, diagnostics, vaccines and an HIV cure. As we build on science and innovation we will need fresh thinking to get us over the remaining obstacles. The cliché is true -- what got us here, won't get us there. We face persistent inequalities, the threat of fewer resources and a growing conspiracy of complacency. (Excerpt)
Prevention gap report.
Geneva, Switzerland, UNAIDS, 2016. [286] p.Efforts to reach fewer than 500 000 new HIV infections by 2020 are off track. This simple conclusion sits atop a complex and diverse global tapestry. Data from 146 countries show that some have achieved declines in new HIV infections among adults of 50% or more over the last 10 years, while many others have not made measurable progress, and yet others have experienced worrying increases in new HIV infections.
90-90-90. An ambitious treatment target to help end the AIDS epidemic.
Geneva, Switzerland, UNAIDS, Joint United Nations Programme on HIV/AIDS, 2014 Oct. 40 p.In December 2013, the UNAIDS Programme Coordinating Board called on UNAIDS to support country- and region-led efforts to establish new targets for HIV treatment scale-up beyond 2015. In response, stakeholder consultations on new targets have been held in all regions of the world. At the global level, stakeholders assembled in a variety of thematic consultations focused on civil society, laboratory medicine, paediatric HIV treatment, adolescents and other key issues. The 90-90-90 UNAIDS target seeks to: 1) By 2020, 90% of all people living with HIV will know their HIV status; 2) By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 3) By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression. Key points: 1) Governments, health experts and civil society must take advantage of the next five-year window to meet the 90-90-90 target to tackle AIDS; 2) Early treatment can reduce infection rates by 90 %; 3) A paradigm shift in HIV/AIDS treatment has seen average drug prices fall from an average of US$15 000 to US$ 80; and 4) Health systems will improve as a result of investment in HIV/AIDS treatment; financing from the international community is indispensable.
How should the post-2015 response to AIDS relate to the drive for universal health coverage?
Global Public Health. 2016 Aug 6; 1-15.The drive for universal health coverage (UHC) now has a great deal of normative impetus, and in combination with the inauguration of the sustainable development goals, has come to be regarded as a means of ensuring the financial basis for the struggle against HIV and AIDS. The argument of this paper is that such thinking is a case of 'the right thing at the wrong time': it seriously underestimates the scale of the work against HIV and AIDS, and the speed with which we need to undertake it, if we are to consolidate the gains we have made to date, let alone reduce it to manageable proportions. The looming 'fiscal crunch' makes the challenges all the more daunting; even in the best circumstances, the time required to establish UHCs capable of providing both essential health services and a very rapid scale-up of the fight against HIV and AIDS is insufficient when set against the urgency of ensuring that AIDS does not eventuate as a global health catastrophe.
90-90-90. On the right track towards the global target.
Geneva, Switzerland, UNAIDS, 2016. [62] p.This report highlights best practices and provides examples of countries that are already coming close to achieving the 90–90–90 targets, which are that 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads. The report outlines steps that are needed to expedite gains towards each of the three 90s. Technological and service delivery innovations rapidly need to be brought to scale, communities must be empowered to lead the push to end the epidemic, new resources must be mobilized to reach the final mile of the response to HIV and steps must urgently be taken to eliminate social and structural barriers to service access.
Guidelines for integrating gender into an M&E framework and system assessment.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2016 May. [37] p. (TR-16-128; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This document offers concrete guidance on how organizations can comprehensively and explicitly integrate gender in their monitoring and evaluation (M&E) systems. It describes how to make each component of a functioning M&E system gender-sensitive and provides guidance on how to assess an M&E system to ensure that gender is fully integrated throughout the system for appropriate collection, compilation, analysis, dissemination, and use of gender data for decision making. This document outlines why it is important to apply a gender lens to M&E processes and structures and contextualizes gender in an M&E system. It then walks you through how to think about gender and address it in each of the components of an M&E system. This guide includes examples of gender-specific assessment questions that can be integrated in an M&E system assessment and provides guidance on how to plan and conduct an M&E system assessment. This guidance document is intended for national health program and M&E managers, subnational health program staff with M&E responsibilities, M&E officers from different agencies or organizations, and development partners who provide M&E support to national and subnational M&E systems.
Fast-track update on investments needed in the AIDS response.
Geneva, Switzerland, UNAIDS, 2016. [20] p. (UNAIDS/JC2842/E)This document gives an update on progress in the Fast-Track Strategy, adopted by the UNAIDS Programme Coordinating Board in October 2015. This strategy sets HIV service coverage targets that must be achieved by 2020 to build sufficient momentum to overcome one of history's greatest public health threats by 2030. For example: Providing antiretroviral therapy (ART) to an additional 12 million people living with HIV in 2020. This will require reaching key populations with a comprehensive package of HIV services. Increasing investment in HIV programs from an estimated USD$19.2 billion in 2014 to USD$26.2 billion by 2020. After 2020, the vast majority of people living with HIV will have been diagnosed. Because of this and other factors, the resources needed for HIV will then steadily decrease to USD$22.3 billion in 2030. Increasing investment in outreach to key populations in low- and middle-income countries for HIV prevention and linkage to HIV testing and treatment. This investment should grow to about 7.2 percent of total investment by 2020, and the estimated resources needed for community-based delivery of ART percent should grow to about 3.8 percent of total investment. The report also states that international assistance should continue to focus on low-income countries, which are less able to fund their HIV response.
UNAIDS 2016–2021 Strategy: On the fast-track to end AIDS.
Geneva, Switzerland, UNAIDS, [2015]. [124] p.In October 2015, the UNAIDS Programme Coordinating Board adopted a new strategy to end the HIV epidemic as a public health threat by 2030. The UNAIDS 2016-2021 Strategy is one of the first in the United Nations system to be aligned to the Sustainable Development Goals framework. This framework, which guides global development policy over the next 15 years, includes ending the HIV epidemic by 2030. The strategy, informed by evidence and rights-based approaches, maps out the UNAIDS Fast-Track approach to accelerate the HIV response over the next five years so as to reach critical HIV prevention and treatment targets and achieve zero discrimination. The strategy also endorses achieving 90–90–90 treatment targets, closing the testing gap, and protecting the health of the 22 million people living with HIV who are still not accessing treatment. Additionally, it urges protecting future generations from acquiring HIV by eliminating all new HIV infections among children, and by ensuring that young people can access needed services for HIV and sexual and reproductive health. The strategy emphasizes that empowering young people, particularly young women, is of utmost importance to preventing HIV. This empowerment includes ending gender-based violence and promoting healthy gender norms.