Access to HIV/AIDS care: a systematic review of socio-cultural determinants in low and high income countries
Identifieur interne : 002B41 ( Main/Curation ); précédent : 002B40; suivant : 002B42Access to HIV/AIDS care: a systematic review of socio-cultural determinants in low and high income countries
Auteurs : Sara Gari [Suisse] ; Camilo Doig-Acu A [États-Unis] ; Tino Smail [Allemagne] ; Jacob Rs Malungo [Zambie] ; Adriane Martin-Hilber [Suisse] ; Sonja Merten [Suisse]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2013.
Abstract
The role of socio-cultural factors in influencing access to HIV/AIDS treatment, care and support is increasingly recognized by researchers, international donors and policy makers. Although many of them have been identified through qualitative studies, the evidence gathered by quantitative studies has not been systematically analysed. To fill this knowledge gap, we did a systematic review of quantitative studies comparing surveys done in high and low income countries to assess the extent to which socio-cultural determinants of access, identified through qualitative studies, have been addressed in epidemiological survey studies.
Ten electronic databases were searched (Cinahl, EMBASE, ISI Web of Science, IBSS, JSTOR, MedLine, Psyinfo, Psyindex and Cochrane). Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Meta-analysis was used to synthesize data comparing studies between low and high income countries.
Thirty-four studies were included in the final review, 21 (62%) done in high income countries and 13 (38%) in low income countries. In low income settings, epidemiological research on access to HIV/AIDS services focused on socio-economic and health system factors while in high income countries the focus was on medical and psychosocial factors. These differences depict the perceived different barriers in the two regions. Common factors between the two regions were also found to affect HIV testing, including stigma, high risk sexual behaviours such as multiple sexual partners and not using condoms, and alcohol abuse. On the other hand, having experienced previous illness or other health conditions and good family communication was associated with adherence to ART uptake. Due to insufficient consistent data, a meta-analysis was only possible on adherence to treatment.
This review offers evidence of the current challenges for interdisciplinary work in epidemiology and public health. Quantitative studies did not systematically address in their surveys important factors identified in qualitative studies as playing a critical role on the access to HIV/AIDS services. The evidences suggest that the problem lies in the exclusion of the qualitative information during the questionnaire design. With the changing face of the epidemic, we need a new and improved research strategy that integrates the results of qualitative studies into quantitative surveys.
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DOI: 10.1186/1472-6963-13-198
PubMed: 23714167
PubMed Central: 3679910
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Martin-Hilber</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Merten, Sonja" sort="Merten, Sonja" uniqKey="Merten S" first="Sonja" last="Merten">Sonja Merten</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Health Services Research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The role of socio-cultural factors in influencing access to HIV/AIDS treatment, care and support is increasingly recognized by researchers, international donors and policy makers. Although many of them have been identified through qualitative studies, the evidence gathered by quantitative studies has not been systematically analysed. To fill this knowledge gap, we did a systematic review of quantitative studies comparing surveys done in high and low income countries to assess the extent to which socio-cultural determinants of access, identified through qualitative studies, have been addressed in epidemiological survey studies.</p></sec><sec><title>Methods</title><p>Ten electronic databases were searched (Cinahl, EMBASE, ISI Web of Science, IBSS, JSTOR, MedLine, Psyinfo, Psyindex and Cochrane). Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Meta-analysis was used to synthesize data comparing studies between low and high income countries.</p></sec><sec><title>Results</title><p>Thirty-four studies were included in the final review, 21 (62%) done in high income countries and 13 (38%) in low income countries. In low income settings, epidemiological research on access to HIV/AIDS services focused on socio-economic and health system factors while in high income countries the focus was on medical and psychosocial factors. These differences depict the perceived different barriers in the two regions. Common factors between the two regions were also found to affect HIV testing, including stigma, high risk sexual behaviours such as multiple sexual partners and not using condoms, and alcohol abuse. On the other hand, having experienced previous illness or other health conditions and good family communication was associated with adherence to ART uptake. Due to insufficient consistent data, a meta-analysis was only possible on adherence to treatment.</p></sec><sec><title>Conclusions</title><p>This review offers evidence of the current challenges for interdisciplinary work in epidemiology and public health. Quantitative studies did not systematically address in their surveys important factors identified in qualitative studies as playing a critical role on the access to HIV/AIDS services. The evidences suggest that the problem lies in the exclusion of the qualitative information during the questionnaire design. With the changing face of the epidemic, we need a new and improved research strategy that integrates the results of qualitative studies into quantitative surveys.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Nguyen, Vk" uniqKey="Nguyen V">VK Nguyen</name></author><author><name sortKey="Klot, J" uniqKey="Klot J">J Klot</name></author><author><name sortKey="Phillips, A" uniqKey="Phillips A">A Phillips</name></author><author><name sortKey="Pirkle, C" uniqKey="Pirkle C">C Pirkle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Merten, S" uniqKey="Merten S">S Merten</name></author><author><name sortKey="Kenter, E" uniqKey="Kenter E">E Kenter</name></author><author><name sortKey="Mckenzie, O" uniqKey="Mckenzie O">O McKenzie</name></author><author><name sortKey="Musheke, M" uniqKey="Musheke M">M Musheke</name></author><author><name sortKey="Ntalasha, H" uniqKey="Ntalasha H">H 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uniqKey="Liberati A">A Liberati</name></author><author><name sortKey="Altman, Dg" uniqKey="Altman D">DG Altman</name></author><author><name sortKey="Tetzlaff, J" uniqKey="Tetzlaff J">J Tetzlaff</name></author><author><name sortKey="Mulrow, C" uniqKey="Mulrow C">C Mulrow</name></author><author><name sortKey="Gotzsche, Pc" uniqKey="Gotzsche P">PC Götzsche</name></author><author><name sortKey="Ioannidis, Jpa" uniqKey="Ioannidis J">JPA Ioannidis</name></author><author><name sortKey="Clarke, M" uniqKey="Clarke M">M Clarke</name></author><author><name sortKey="Devereaux, Pj" uniqKey="Devereaux P">PJ Devereaux</name></author><author><name sortKey="Kleijnen, J" uniqKey="Kleijnen J">J Kleijnen</name></author><author><name sortKey="Moher, D" uniqKey="Moher D">D Moher</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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