Wandera Stephen Ojiambo, Nangendo Joanita, Kinengyere Alison Annet, Ocan Moses, Katahoire Anne, Semitala Fred C, Bogart Laura, Kamya Moses
Population Studies, Makerere University, Kampala, Uganda
Makerere University, Kampala, Uganda.
BMJ Open. 2025 Mar 18;15(3):e091718. doi: 10.1136/bmjopen-2024-091718.
Data are limited on the impact of stigma (stigma associated with HIV and/or stigma related to old age (ageism) or both) on linkage to the HIV care cascade among older persons (aged 50 years and older) in sub-Saharan Africa (SSA). Studies have documented the prevalence and determinants of HIV testing, antiretroviral therapy (ART) use and viral load suppression among older people in Africa. However, there is a need to conduct a systematic review to synthesise the findings on the impact of stigma on the HIV care cascade among older people in SSA. The objective of this systematic review is to collate the findings on the impact of stigma on the HIV care cascade among older people aged 50 years and older in SSA. The major research question is: what is the impact of stigma on the HIV care cascade among older persons aged 50 years and older in SSA?
We will search MEDLINE via PubMed, Web of Science Collection, Academic Search Premier from the EBSCO platform, Cochrane Central, JBI EBP, Global Health, Social Policy and Practice and Health Management Information Consortium for articles published in English from 2000 to June 2024. The search strategy will include variations of the following terms: HIV, HIV cascade, HIV testing, HIV care or linkage to care, retention in care, viral suppression, older persons, stigma, HIV-related stigma, age-related stigma, ageism, discrimination and intersectional stigma. In terms of study characteristics, the following will be included: epidemiological studies/observational studies/randomised controlled trials and qualitative studies on the HIV care cascade (ie, HIV testing, linkage to care, retention and viral suppression). We will restrict eligibility by focusing on the older population (older persons aged 50 years and older living with HIV) in SSA. The planned limits include timing (2000-2024), geographical coverage (SSA), language (English), copyright (open access publications) and age of the population (50 years and older). The primary and secondary outcomes are drawn from the HIV care cascade, including HIV testing, linkage to care, retention in care and adherence to ART.
Ethics approval is not needed since this is a systematic review based on published data. Dissemination will be done by submitting scientific articles to academic peer-reviewed journals. We will also present the results at relevant conferences and meetings.
CRD42024534675.
关于耻辱感（与艾滋病毒相关的耻辱感和/或与老年相关的耻辱感（年龄歧视）或两者兼有）对撒哈拉以南非洲（SSA）50岁及以上老年人艾滋病护理连续过程的影响的数据有限。研究记录了非洲老年人艾滋病毒检测、抗逆转录病毒疗法（ART）使用和病毒载量抑制的患病率及决定因素。然而，有必要进行系统综述，以综合关于耻辱感对SSA老年人艾滋病护理连续过程影响的研究结果。本系统综述的目的是整理关于耻辱感对SSA 50岁及以上老年人艾滋病护理连续过程影响的研究结果。主要研究问题是：耻辱感对SSA 50岁及以上老年人艾滋病护理连续过程有何影响？
我们将通过PubMed搜索MEDLINE、Web of Science数据库、EBSCO平台的学术搜索全文数据库、Cochrane中心、JBI循证医学、全球健康、社会政策与实践以及健康管理信息联盟，查找2000年至2024年6月发表的英文文章。搜索策略将包括以下术语的变体：艾滋病毒、艾滋病毒护理连续过程、艾滋病毒检测、艾滋病毒护理或护理联系、护理留存、病毒抑制、老年人、耻辱感、与艾滋病毒相关的耻辱感、与年龄相关的耻辱感、年龄歧视、歧视和交叉耻辱感。在研究特征方面，将包括以下内容：关于艾滋病毒护理连续过程（即艾滋病毒检测、护理联系、留存和病毒抑制）的流行病学研究/观察性研究/随机对照试验和定性研究。我们将把纳入标准限定为关注SSA的老年人群（50岁及以上感染艾滋病毒的老年人）。计划的限制包括时间（2000 - 2024年）、地理覆盖范围（SSA）、语言（英语）、版权（开放获取出版物）和人群年龄（50岁及以上）。主要和次要结局均来自艾滋病毒护理连续过程，包括艾滋病毒检测、护理联系、护理留存和抗逆转录病毒疗法的依从性。
由于这是一项基于已发表数据的系统综述，无需伦理批准。传播将通过向学术同行评审期刊提交科学文章来完成。我们还将在相关会议上展示研究结果。
PROSPERO注册号：CRD42024534675。
