Enhancing Public Health HIV Interventions: A Qualitative Meta-Synthesis and Systematic Review of Studies to Improve Linkage to Care, Adherence, and Retention

EBioMedicine

Mellanye Lackey¹  Brian Hall²  Meg Doherty³  Rachel Beanland³  John Best⁴  Haochu Li⁵  Lai Sze Tso⁵  Ka-lon Sou⁵  Gifty Marley⁵  Joseph D. Tucker⁵  Qingyan Ma⁵  Zachary C. Rich⁵ 

[1] Eccles Health Sciences Library, University of Utah, Salt Lake City, UT, USA;Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macau, China;HIV Department, World Health Organization, Geneva, Switzerland;School of Medicine, University of California, San Francisco, San Francisco, USA;University of North Carolina Project-China, Guangzhou, China;

关键词: HIV;    Public health;    Intervention;    Qualitative;    Systematic review;   

DOI  :  10.1016/j.ebiom.2017.01.036

来源: DOAJ

【 摘 要 】

Although HIV services are expanding, few have reached the scale necessary to support universal viral suppression of individuals living with HIV. The purpose of this systematic review was to summarize the qualitative evidence evaluating public health HIV interventions to enhance linkage to care, antiretroviral drug (ARV) adherence, and retention in care. We searched 19 databases without language restrictions. The review collated data from three separate qualitative evidence reviews addressing each of the three outcomes along the care continuum. 21,738 citations were identified and 24 studies were included in the evidence review. Among low and middle-income countries in Africa, men living with HIV had decreased engagement in interventions compared to women and this lack of engagement among men also influenced the willingness of their partners to engage in services. Four structural issues (poverty, unstable housing, food insecurity, lack of transportation) mediated the feasibility and acceptability of public health HIV interventions. Individuals living with HIV identified unmet mental health needs that interfered with their ability to access HIV services. Persistent social and cultural factors contribute to disparities in HIV outcomes across the continuum of care, shaping the context of service delivery among important subpopulations.

【 授权许可】

Unknown