Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analyses
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 r...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971222004325 |
| _version_ | 1798004418192343040 |
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| author | Terefe Gone Fuge George Tsourtos Emma R Miller |
| author_facet | Terefe Gone Fuge George Tsourtos Emma R Miller |
| author_sort | Terefe Gone Fuge |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T12:23:22Z |
| format | Article |
| id | doaj.art-28581bf0cfd54bcca34d936787a5ed5d |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-11T12:23:22Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-28581bf0cfd54bcca34d936787a5ed5d2022-12-22T04:24:02ZengElsevierInternational Journal of Infectious Diseases1201-97122022-09-01122885904Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analysesTerefe Gone Fuge0George Tsourtos1Emma R Miller2Corresponding author.; College of Medicine and Public Health, Flinders University, Adelaide, AustraliaCollege of Medicine and Public Health, Flinders University, Adelaide, AustraliaCollege of Medicine and Public Health, Flinders University, Adelaide, AustraliaObjectives: 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.http://www.sciencedirect.com/science/article/pii/S1201971222004325HIVLinkage to careAntiretroviral therapy initiationFactorsAdultsSub-Saharan Africa |
| spellingShingle | Terefe Gone Fuge George Tsourtos Emma R Miller Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analyses International Journal of Infectious Diseases HIV Linkage to care Antiretroviral therapy initiation Factors Adults Sub-Saharan Africa |
| title | Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analyses |
| title_full | Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analyses |
| title_fullStr | Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analyses |
| title_full_unstemmed | Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analyses |
| title_short | Risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with HIV in sub-Saharan Africa: a systematic review and meta-analyses |
| title_sort | risk factors for late linkage to care and delayed antiretroviral therapy initiation among adults with hiv in sub saharan africa a systematic review and meta analyses |
| topic | HIV Linkage to care Antiretroviral therapy initiation Factors Adults Sub-Saharan Africa |
| url | http://www.sciencedirect.com/science/article/pii/S1201971222004325 |
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