Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings.
Identifieur interne : 001128 ( PubMed/Checkpoint ); précédent : 001127; suivant : 001129Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings.
Auteurs : Michael L. Scanlon [Kenya] ; Rachel C. VreemanSource :
- HIV/AIDS (Auckland, N.Z.) [ 1179-1373 ] ; 2013.
Abstract
The rollout of antiretroviral therapy (ART) significantly reduced human immunodeficiency virus (HIV)-related morbidity and mortality, but good clinical outcomes depend on access and adherence to treatment. In resource-limited settings, where over 90% of the world's HIV-infected population resides, data on barriers to treatment are emerging that contribute to low rates of uptake in HIV testing, linkage to and retention in HIV care systems, and suboptimal adherence rates to therapy. A review of the literature reveals limited evidence to inform strategies to improve access and adherence with the majority of studies from sub-Saharan Africa. Data from observational studies and randomized controlled trials support home-based, mobile and antenatal care HIV testing, task-shifting from doctor-based to nurse-based and lower level provider care, and adherence support through education, counseling and mobile phone messaging services. Strategies with more limited evidence include targeted HIV testing for couples and family members of ART patients, decentralization of HIV care, including through home- and community-based ART programs, and adherence promotion through peer health workers, treatment supporters, and directly observed therapy. There is little evidence for improving access and adherence among vulnerable groups such as women, children and adolescents, and other high-risk populations and for addressing major barriers. Overall, studies are few in number and suffer from methodological issues. Recommendations for further research include health information technology, social-level factors like HIV stigma, and new research directions in cost-effectiveness, operations, and implementation. Findings from this review make a compelling case for more data to guide strategies to improve access and adherence to treatment in resource-limited settings.
DOI: 10.2147/HIV.S28912
PubMed: 23326204
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings.</title><author><name sortKey="Scanlon, Michael L" sort="Scanlon, Michael L" uniqKey="Scanlon M" first="Michael L" last="Scanlon">Michael L. Scanlon</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA ; USAID, Academic Model Providing Access to Healthcare (AMPATH) Partnership, Eldoret, Kenya.</nlm:affiliation><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA ; USAID, Academic Model Providing Access to Healthcare (AMPATH) Partnership, Eldoret</wicri:regionArea><wicri:noRegion>Eldoret</wicri:noRegion></affiliation></author><author><name sortKey="Vreeman, Rachel C" sort="Vreeman, Rachel C" uniqKey="Vreeman R" first="Rachel C" last="Vreeman">Rachel C. Vreeman</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23326204</idno><idno type="pmid">23326204</idno><idno type="doi">10.2147/HIV.S28912</idno><idno type="wicri:Area/PubMed/Corpus">001657</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001657</idno><idno type="wicri:Area/PubMed/Curation">001657</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001657</idno><idno type="wicri:Area/PubMed/Checkpoint">001657</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001657</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings.</title><author><name sortKey="Scanlon, Michael L" sort="Scanlon, Michael L" uniqKey="Scanlon M" first="Michael L" last="Scanlon">Michael L. Scanlon</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA ; USAID, Academic Model Providing Access to Healthcare (AMPATH) Partnership, Eldoret, Kenya.</nlm:affiliation><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA ; USAID, Academic Model Providing Access to Healthcare (AMPATH) Partnership, Eldoret</wicri:regionArea><wicri:noRegion>Eldoret</wicri:noRegion></affiliation></author><author><name sortKey="Vreeman, Rachel C" sort="Vreeman, Rachel C" uniqKey="Vreeman R" first="Rachel C" last="Vreeman">Rachel C. Vreeman</name></author></analytic><series><title level="j">HIV/AIDS (Auckland, N.Z.)</title><idno type="ISSN">1179-1373</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The rollout of antiretroviral therapy (ART) significantly reduced human immunodeficiency virus (HIV)-related morbidity and mortality, but good clinical outcomes depend on access and adherence to treatment. In resource-limited settings, where over 90% of the world's HIV-infected population resides, data on barriers to treatment are emerging that contribute to low rates of uptake in HIV testing, linkage to and retention in HIV care systems, and suboptimal adherence rates to therapy. A review of the literature reveals limited evidence to inform strategies to improve access and adherence with the majority of studies from sub-Saharan Africa. Data from observational studies and randomized controlled trials support home-based, mobile and antenatal care HIV testing, task-shifting from doctor-based to nurse-based and lower level provider care, and adherence support through education, counseling and mobile phone messaging services. Strategies with more limited evidence include targeted HIV testing for couples and family members of ART patients, decentralization of HIV care, including through home- and community-based ART programs, and adherence promotion through peer health workers, treatment supporters, and directly observed therapy. There is little evidence for improving access and adherence among vulnerable groups such as women, children and adolescents, and other high-risk populations and for addressing major barriers. Overall, studies are few in number and suffer from methodological issues. Recommendations for further research include health information technology, social-level factors like HIV stigma, and new research directions in cost-effectiveness, operations, and implementation. Findings from this review make a compelling case for more data to guide strategies to improve access and adherence to treatment in resource-limited settings.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">23326204</PMID><DateCreated><Year>2013</Year><Month>01</Month><Day>17</Day></DateCreated><DateCompleted><Year>2013</Year><Month>01</Month><Day>18</Day></DateCompleted><DateRevised><Year>2013</Year><Month>05</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">1179-1373</ISSN><JournalIssue CitedMedium="Print"><Volume>5</Volume><PubDate><Year>2013</Year></PubDate></JournalIssue><Title>HIV/AIDS (Auckland, N.Z.)</Title><ISOAbbreviation>HIV AIDS (Auckl)</ISOAbbreviation></Journal><ArticleTitle>Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings.</ArticleTitle><Pagination><MedlinePgn>1-17</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2147/HIV.S28912</ELocationID><Abstract><AbstractText>The rollout of antiretroviral therapy (ART) significantly reduced human immunodeficiency virus (HIV)-related morbidity and mortality, but good clinical outcomes depend on access and adherence to treatment. In resource-limited settings, where over 90% of the world's HIV-infected population resides, data on barriers to treatment are emerging that contribute to low rates of uptake in HIV testing, linkage to and retention in HIV care systems, and suboptimal adherence rates to therapy. A review of the literature reveals limited evidence to inform strategies to improve access and adherence with the majority of studies from sub-Saharan Africa. Data from observational studies and randomized controlled trials support home-based, mobile and antenatal care HIV testing, task-shifting from doctor-based to nurse-based and lower level provider care, and adherence support through education, counseling and mobile phone messaging services. Strategies with more limited evidence include targeted HIV testing for couples and family members of ART patients, decentralization of HIV care, including through home- and community-based ART programs, and adherence promotion through peer health workers, treatment supporters, and directly observed therapy. There is little evidence for improving access and adherence among vulnerable groups such as women, children and adolescents, and other high-risk populations and for addressing major barriers. Overall, studies are few in number and suffer from methodological issues. Recommendations for further research include health information technology, social-level factors like HIV stigma, and new research directions in cost-effectiveness, operations, and implementation. Findings from this review make a compelling case for more data to guide strategies to improve access and adherence to treatment in resource-limited settings.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Scanlon</LastName><ForeName>Michael L</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA ; USAID, Academic Model Providing Access to Healthcare (AMPATH) Partnership, Eldoret, Kenya.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vreeman</LastName><ForeName>Rachel C</ForeName><Initials>RC</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>01</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>New Zealand</Country><MedlineTA>HIV AIDS 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Version="1">17438479</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Clin Infect Dis. 2007 Sep 15;45(6):770-8</RefSource><PMID Version="1">17712763</PMID></CommentsCorrections></CommentsCorrectionsList><OtherID Source="NLM">PMC3544393</OtherID><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">HIV</Keyword><Keyword MajorTopicYN="N">access</Keyword><Keyword MajorTopicYN="N">adherence</Keyword><Keyword MajorTopicYN="N">antiretroviral therapy</Keyword><Keyword MajorTopicYN="N">resource-limited settings</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>1</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>1</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>1</Month><Day>18</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23326204</ArticleId><ArticleId IdType="doi">10.2147/HIV.S28912</ArticleId><ArticleId IdType="pii">hiv-5-001</ArticleId><ArticleId IdType="pmc">PMC3544393</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Kenya</li></country></list><tree><noCountry><name sortKey="Vreeman, Rachel C" sort="Vreeman, Rachel C" uniqKey="Vreeman R" first="Rachel C" last="Vreeman">Rachel C. Vreeman</name></noCountry><country name="Kenya"><noRegion><name sortKey="Scanlon, Michael L" sort="Scanlon, Michael L" uniqKey="Scanlon M" first="Michael L" last="Scanlon">Michael L. Scanlon</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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