A rapid review and synthesis of the effectiveness of programmes initiating community-based antiretroviral therapy in sub-Saharan Africa

Southern African Journal of HIV Medicine

Field Value
Title A rapid review and synthesis of the effectiveness of programmes initiating community-based antiretroviral therapy in sub-Saharan Africa
Creator Chimatira, Raymond Ross, Andrew
Subject Public Health; Medicine community-based ART; HIV; interventions; ART initiation; retention; attrition; viral suppression; sub-Saharan Africa
Description Background: Community-based antiretroviral therapy initiation (CB-ARTi) has the potential to reduce attrition by increasing access to care, reducing patient costs, decongesting clinics and ensuring improved uptake of ART. There is a paucity of research that identifies successful implementation of CB-ARTi in sub-Saharan Africa (SSA).Objectives: The aim of the study was to review and describe the evidence on the effectiveness of CB-ARTi programmes that start ART in communities in comparison with the current standards of care in SSA.Methods: A rapid review of grey and published peer-reviewed literature between January 2009 and July 2019, by using PubMed, PDQ-Evidence, Google Scholar, clinical trial databases and major HIV (human immunodeficiency virus) conference websites, was conducted. Search terms used included ‘community-based’, ‘home initiation community models’, ‘antiretroviral therapy’, ‘clinical outcomes’, ‘viral suppression’, ‘retention in care’, ‘loss to follow-up’, ‘HIV’ and ‘sub-Saharan Africa’.Results: The search yielded 90 articles and reports following the removal of duplicates. After initial screening and full-text screening, six articles remained and were included in the qualitative narrative synthesis. This included four randomised control trials and two cohort studies of specific interventions comparing CB-ARTi with the standard of care in SSA. There is evidence that CB-ARTi can increase access to HIV-testing services, linkage to ART, retention in care and viral suppression rates and is possibly not inferior to facility-based healthcare.Conclusion: CB-ARTi has the potential to increase access to HIV services to people living with HIV in SSA. The results mentioned previously suggest that CB-ARTi models could prove to be equal and possibly not inferior to facility-based ones and warrant further investigation.
Publisher AOSIS
Date 2020-11-05
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Rapid Review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v21i1.1153
Source Southern African Journal of HIV Medicine; Vol 21, No 1 (2020); 9 pages 2078-6751 1608-9693
Language eng
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https://sajhivmed.org.za/index.php/hivmed/article/view/1153/2062 https://sajhivmed.org.za/index.php/hivmed/article/view/1153/2061 https://sajhivmed.org.za/index.php/hivmed/article/view/1153/2063 https://sajhivmed.org.za/index.php/hivmed/article/view/1153/2060
Coverage Sub-Saharan Africa — —
Rights Copyright (c) 2020 Raymond Chimatira, Andrew Ross https://creativecommons.org/licenses/by/4.0