Babatunde Abdulhammed O, Akin-Ajani Oluwawapelumi D, Abdullateef Ridwanullah O, Togunwa Taofeeq O, Isah Haroun O
Department of Medicine and Surgery, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Healthy Africans Platform, Ibadan, Nigeria.
J Med Virol. 2023 Jan;95(1):e28320. doi: 10.1002/jmv.28320.
Africa is responsible for two-thirds of the global total of new HIV infections. South Africa, Nigeria, Mozambique, Uganda, Tanzania, Zambia, Zimbabwe, Kenya, Malawi, and Ethiopia were responsible for 80% of HIV cases in Africa in 2014 according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). This study assesses antiretroviral coverage strategies implemented by these countries after the initiation of the "Fast-Track strategy to end the AIDS epidemic by 2030." Data reported in this review were obtained from different e-bibliographic including PubMed, Google Scholar, and Research Gate. Key terms were "Antiretroviral therapy," "Antiretroviral treatment," "HIV treatment," "HIV medication," "HIV/AIDS therapy," "HIV/AIDS treatment" + each of the countries listed earlier. We also extracted data on antiretroviral therapy (ART) coverage from the UNAIDS database. About 50 papers published from 2015 to 2021 met the inclusion criteria. All 10 countries have experienced an increase in ART coverage from 2015 to 2020 with an average of 47.6% increment. Nigeria recorded the highest increase in the rate of ART coverage (72% increase) while Ethiopia had the least (30%). New strategies adopted to increase ART coverage and retention in most countries were community-based models and the use of mobile health technology rather than clinic-based. These strategies focus on promoting task shifting, door-to-door access to HIV services, and a long-term supply of antiretroviral medications. Most of these strategies are still in the piloting stage. However, some new strategies and frameworks have been adopted nationwide in countries like Mozambique, Tanzania, Zambia, Zimbabwe, Kenya, and Malawi. Identified challenges include lack of funding, inadequate testing and surveillance services, poor digital penetration, and cultural/religious beliefs. The adoption of community-based and digital health strategies could have contributed to increased ART coverage and retention. African countries should facilitate nationwide scaling of ART coverage strategies to attain the 95-95-95 goal by 2030.
全球新增艾滋病毒感染病例总数的三分之二来自非洲。根据联合国艾滋病规划署（UNAIDS）的数据，2014年，南非、尼日利亚、莫桑比克、乌干达、坦桑尼亚、赞比亚、津巴布韦、肯尼亚、马拉维和埃塞俄比亚的艾滋病毒病例占非洲的80%。本研究评估了这些国家在启动“到2030年终结艾滋病流行的快车道战略”后实施的抗逆转录病毒治疗覆盖策略。本综述中报告的数据来自不同的电子文献数据库，包括PubMed、谷歌学术和ResearchGate。关键词为“抗逆转录病毒疗法”“抗逆转录病毒治疗”“艾滋病毒治疗”“艾滋病毒药物”“艾滋病毒/艾滋病疗法”“艾滋病毒/艾滋病治疗”以及上述每个国家。我们还从UNAIDS数据库中提取了抗逆转录病毒疗法（ART）覆盖的数据。2015年至2021年发表的约50篇论文符合纳入标准。从2015年到2020年，所有10个国家的ART覆盖率均有所上升，平均增幅为47.6%。尼日利亚的ART覆盖率增幅最高（增长72%），而埃塞俄比亚的增幅最小（增长30%）。大多数国家为提高ART覆盖率和保留率而采用的新策略是以社区为基础的模式和移动健康技术的应用，而非基于诊所的模式。这些策略侧重于促进任务转移、上门提供艾滋病毒服务以及抗逆转录病毒药物的长期供应。这些策略大多仍处于试点阶段。然而，莫桑比克、坦桑尼亚、赞比亚、津巴布韦、肯尼亚和马拉维等国已在全国范围内采用了一些新策略和框架。已确定的挑战包括资金短缺、检测和监测服务不足、数字普及率低以及文化/宗教信仰问题。采用基于社区和数字健康的策略可能有助于提高ART覆盖率和保留率。非洲国家应推动ART覆盖策略在全国范围内的推广，以在2030年前实现95-95-95目标。
