撒哈拉以南非洲国家提高抗逆转录病毒疗法（ART）依从性的障碍和干预措施：系统评价方案。
Adherence barriers and interventions to improve ART adherence in Sub-Saharan African countries: A systematic review protocol.
机构信息
Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
出版信息
PLoS One. 2022 Jun 15;17(6):e0269252. doi: 10.1371/journal.pone.0269252. eCollection 2022.
BACKGROUND
The HIV/AIDS pandemic continues to be a major public health concern, particularly in Sub-Saharan Africa (SSA). Despite efforts to reduce new infections and deaths with the use of antiretroviral therapy (ART), SSA countries continue to bear the heaviest burden of HIV/AIDS globally, accounting for two-thirds of global new infections. The goal of this review is to identify common barriers to ART adherence as well as common effective interventions that can be implemented across SSA countries to improve ART adherence.
METHODS
A systematic review of published studies on adult HIV-positive patients aged 15 or above, that have assessed the barriers to ART adherence and interventions improving patients' adherence to ART in SSA countries shall be conducted. We will conduct electronic searches for articles that have been published starting from January 2010 onwards. The databases that shall be searched will include Medline Ovid, CINAHL, Embase, and Scopus. The review will include experimental and quasi-experimental studies such as randomized and non-randomized controlled trials as well as comparative before and after studies, and observational studies-cross-sectional studies, cohort studies, prospective and retrospective studies. Two independent reviewers will screen all identified studies, extract data and appraise the methodological quality of the studies using standard critical appraisal tools from the Joanna Briggs Institute. The extracted data will be subjected to a meta-analysis and narrative synthesis.
DISCUSSION
This review will synthesize existing evidence on ART adherence barriers and strategies for improving patient adherence to ART in SSA countries. It will identify common barriers to adherence and common interventions proven to improve adherence across SSA. We anticipate that the findings of this review will provide information policy makers and stakeholders involved in the fight against HIV, will find useful in deriving better ways of not only retaining patients on treatment but having them adhere to their treatment.
REVIEW REGISTRATION
This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number CRD42021262256.
背景
艾滋病疫情仍然是一个主要的公共卫生关注点，特别是在撒哈拉以南非洲（SSA）地区。尽管通过使用抗逆转录病毒疗法（ART）来努力减少新的感染和死亡，但 SSA 国家仍然承担着全球艾滋病疫情的最大负担，占全球新感染人数的三分之二。本综述的目的是确定影响 SSA 国家抗逆转录病毒治疗（ART）依从性的常见障碍，以及可以在整个 SSA 国家实施的常见有效干预措施，以提高 ART 依从性。
方法
我们将对发表的关于年龄在 15 岁或以上的成年 HIV 阳性患者的研究进行系统综述，评估 SSA 国家影响 ART 依从性的障碍以及改善患者 ART 依从性的干预措施。我们将从 2010 年 1 月开始对文章进行电子检索。要搜索的数据库将包括 Medline Ovid、CINAHL、Embase 和 Scopus。综述将包括实验性和准实验性研究，如随机和非随机对照试验以及比较性前后研究，以及观察性研究——横断面研究、队列研究、前瞻性和回顾性研究。两名独立的评审员将筛选所有确定的研究，使用 Joanna Briggs 研究所的标准批判性评价工具提取数据并评价研究的方法学质量。提取的数据将进行荟萃分析和叙述性综合。
讨论
本综述将综合现有的关于 SSA 国家影响 ART 依从性的障碍和改善患者 ART 依从性的策略的证据。它将确定影响依从性的常见障碍和经证明可以提高 SSA 依从性的常见干预措施。我们预计，本综述的结果将为参与抗击艾滋病的决策者和利益相关者提供信息，这将有助于找到不仅保留患者治疗而且使其坚持治疗的更好方法。
综述注册
本方案已在国际前瞻性系统评价注册库（PROSPERO）中注册；注册编号 CRD42021262256。
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