AI Article Synopsis
- Late treatment initiation of antiretroviral therapy (ART) can undermine both clinical effectiveness and public health benefits, particularly in sub-Saharan Africa (SSA), where there's a lack of comprehensive evidence on interventions.
- A systematic review analyzed 46 studies, focusing on factors influencing HIV care outcomes among adults in SSA between 2015 and 2021, identifying significant barriers linked to healthcare delivery, perceptions, and demographic factors.
- The findings call for patient-centered interventions to address and mitigate these barriers to improve timely access to care and ART initiation for adults with HIV in the region.
Article Abstract
Objectives: Late treatment initiation threatens the clinical and public health benefits of antiretroviral therapy (ART). Quantitative synthesizes of the existing evidence related to this are lacking in sub-Saharan Africa (SSA), which would help ascertain the best evidence-based interventions. This review aimed to systematically synthesize the available literature on factors affecting linkage to care and ART initiation among adults with HIV in SSA.
Methods: Systematic searches were undertaken on four databases to identify observational studies investigating factors affecting both HIV care outcomes among adults (age ≥19 years) in SSA and were published between January 1, 2015 and June 1, 2021. RevMan-5 software was used to conduct meta-analyses and Mantel-Haenszel statistics to pool outcomes with a 95% confidence interval and <0.05 level of significance.
Results: A total of 46 studies were included in the systematic review, of which 18 fulfilled requirements for the meta-analysis. In both narrative review and meta-analyses, factors related to health care delivery, individual perception, and sociodemographic circumstances were associated with late linkage to care and delays in ART initiation.
Conclusion: This review identified a range of risk factors for late linkage to care and delayed ART initiation among adults with HIV in SSA. We recommend implementation of patient-centered intervention approaches to alleviate these barriers.
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| http://dx.doi.org/10.1016/j.ijid.2022.07.037 | DOI Listing |
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