University of California, 2121 Berkeley Way, MC 7360, Berkeley, CA, 94720, USA.
Community Development, Gender, Elderly, and Children, Ministry of Health, Dar es Salaam, Tanzania.
Curr HIV/AIDS Rep. 2019 Aug;16(4):292-303. doi: 10.1007/s11904-019-00451-8.
PURPOSE OF THE REVIEW: In 2015, antiretroviral therapy (ART) was recommended for all people living with HIV (PLHIV) regardless of CD4 count ("Treat All"). To better understand how to improve linkage to care under these new guidelines, we conducted a systematic review of studies evaluating linkage interventions in Sub-Saharan Africa under Treat All. RECENT FINDINGS: We identified 14 eligible articles and qualitatively analyzed the effectiveness of the interventions. Increases in linkage were reported by supply-side and counseling interventions. Mobile testing and economic incentives did not increase linkage. Given the lag time between adoption and implementation, only two of the studies were conducted in a Treat All setting. None of the interventions specifically focused on re-linking PLHIV who had disengaged from care. Future studies must design interventions that target not only newly diagnosed or treatment naïve PLHIV, but should explicitly focus on PLHIV who have disengaged from care.
目的综述:2015 年,抗逆转录病毒疗法(ART)被推荐用于所有艾滋病毒感染者(PLHIV),无论 CD4 计数如何(“全面治疗”)。为了更好地了解如何在这些新指南下改善护理衔接,我们对撒哈拉以南非洲地区在“全面治疗”下评估衔接干预措施的研究进行了系统评价。
最新发现:我们确定了 14 篇合格的文章,并对干预措施的有效性进行了定性分析。供应方干预和咨询干预措施报告了衔接率的提高。移动检测和经济激励措施并没有增加联系。鉴于采用和实施之间的时间滞后,只有两项研究是在“全面治疗”环境中进行的。这些干预措施都没有专门针对已经脱离护理的 PLHIV 重新建立联系。未来的研究必须设计针对新诊断或初次治疗的 PLHIV 的干预措施,并且应该明确关注已经脱离护理的 PLHIV。
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