Departments of Medicine and Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
AIDS Care. 2024 Jan;36(1):1-16. doi: 10.1080/09540121.2023.2240071. Epub 2023 Aug 22.
Economic insecurity and poverty present major barriers to HIV care for young people. We conducted a systematic review of the current evidence for the effect of economic interventions on HIV care outcomes among pediatric populations encompassing young children, adolescents, and youth (ages 0-24). We conducted a search of PubMed MEDLINE, Cochrane, Embase, Scopus, CINAHL, and Global Health databases on October 12, 2022 using a search strategy curated by a medical librarian. Studies included economic interventions targeting participants <25 years in age which measured clinical HIV outcomes. Study characteristics, care outcomes, and quality were independently assessed, and findings were synthesized. Title/abstract screening was performed for 1934 unique records. Thirteen studies met inclusion criteria, reporting on nine distinct interventions. Economic interventions included incentives ( = 5), savings and lending programs ( = 3), and government cash transfers ( = 1). Study designs included three randomized controlled trials, an observational cohort study, a matched retrospective cohort study, and pilot intervention studies. While evidence is very limited, some promising findings were observed supporting retention and viral suppression, particularly for those with suboptimal care engagement or with detectable viral load. There is a need to further study and optimize economic interventions for children and adolescents living with HIV.
经济不安全和贫困是阻碍年轻人获得艾滋病毒护理的主要障碍。我们对当前关于经济干预措施对涵盖婴幼儿、青少年和青年（0-24 岁）的儿科人群艾滋病毒护理结果影响的证据进行了系统评价。我们于 2022 年 10 月 12 日在 PubMed MEDLINE、Cochrane、Embase、Scopus、CINAHL 和全球卫生数据库中进行了搜索，使用了由医学图书馆员策划的搜索策略。研究包括针对年龄<25 岁的参与者的经济干预措施，这些措施衡量了临床艾滋病毒结果。独立评估了研究特征、护理结果和质量，并对研究结果进行了综合。对 1934 条独特记录进行了标题/摘要筛选。13 项研究符合纳入标准，报告了 9 项不同的干预措施。经济干预措施包括激励措施（ = 5）、储蓄和贷款计划（ = 3）和政府现金转移（ = 1）。研究设计包括三项随机对照试验、一项观察性队列研究、一项匹配的回顾性队列研究和试点干预研究。尽管证据非常有限，但观察到一些有希望的发现支持保留和病毒抑制，特别是对那些参与护理不理想或病毒载量可检测的人。需要进一步研究和优化针对艾滋病毒儿童和青少年的经济干预措施。
