Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review
Kwadwo Koduah Owusu,1 Raphael Adu-Gyamfi,2 Ahmed Zamzam1 1School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK; 2National AIDS/STI Control Programme, Ghana Health Service, Korle-Bu, Accra, GhanaCorrespondence: Raphael Adu-GyamfiNational AIDS/STI Control Programme, Ghan...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-12-01
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| Series: | HIV/AIDS: Research and Palliative Care |
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| Online Access: | https://www.dovepress.com/strategies-to-improve-linkage-to-hiv-care-in-urban-areas-of-sub-sahara-peer-reviewed-article-HIV |
| _version_ | 1818347083766169600 |
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| author | Koduah Owusu K Adu-Gyamfi R Ahmed Z |
| author_facet | Koduah Owusu K Adu-Gyamfi R Ahmed Z |
| author_sort | Koduah Owusu K |
| collection | DOAJ |
| description | Kwadwo Koduah Owusu,1 Raphael Adu-Gyamfi,2 Ahmed Zamzam1 1School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK; 2National AIDS/STI Control Programme, Ghana Health Service, Korle-Bu, Accra, GhanaCorrespondence: Raphael Adu-GyamfiNational AIDS/STI Control Programme, Ghana Health Service, Korle-bu, Accra, GhanaTel +233267075458Email ralphgyamfi@gmail.comAbstract: Of the 37 million people estimated to be living with HIV globally in 2017, about 24.7 million were in the sub-Saharan Africa region, which has been and remains worst affected by the epidemic. Enrolment of newly diagnosed individuals into care in the region, however, remains poor with up to 54% not being linked to care. Linkage to care is a very important step in the HIV cascade as it is the precursor to initiating antiretroviral therapy (ART), retention in care, and viral suppression. A systematic review was conducted to gather information regarding the strategies that have been documented to increase linkage to care of Persons living with HIV(PLHIV) in urban areas of sub-Saharan Africa. An electronic search was conducted on Scopus, Cochrane central, CINAHL Plus, PubMed and OpenGrey for linkage strategies implemented from 2006. A total of 189 potentially relevant citations were identified, of which 7 were eligible for inclusion. The identified strategies were categorized using themes from literature. The most common strategies included: health system interventions (i.e. comprehensive care, task shifting); patient convenience and accessibility (i.e. immediate CD4 count testing, immediate ART initiation, community HIV testing); behavior interventions and peer support (i.e. assisted partner services, care facilitation, mobile phone appointment reminders, health education) and incentives (i.e. non-cash financial incentives and transport reimbursement). Several strategies showed favorable outcomes: comprehensive care, immediate CD4 count testing, immediate ART initiation, and assisted partner services. Assisted partner services, same day home-based ART initiation, combination intervention strategies and point-of-care CD4 testing significantly improved linkage to care in urban settings of sub-Saharan African region. They can be delivered either in a health facility or in the community but should be facilitated by health workers. There is, however, the need to conduct more linkage-specific studies in the sub-region.Keywords: linkage to care, human immunodeficiency virus, acquired immune deficiency syndrome, urban, sub-Saharan Africa, adults |
| first_indexed | 2024-12-13T17:28:32Z |
| format | Article |
| id | doaj.art-804f068689a5459cb725afbe077147b2 |
| institution | Directory Open Access Journal |
| issn | 1179-1373 |
| language | English |
| last_indexed | 2024-12-13T17:28:32Z |
| publishDate | 2019-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | HIV/AIDS: Research and Palliative Care |
| spelling | doaj.art-804f068689a5459cb725afbe077147b22022-12-21T23:37:07ZengDove Medical PressHIV/AIDS: Research and Palliative Care1179-13732019-12-01Volume 1132133250141Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic ReviewKoduah Owusu KAdu-Gyamfi RAhmed ZKwadwo Koduah Owusu,1 Raphael Adu-Gyamfi,2 Ahmed Zamzam1 1School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK; 2National AIDS/STI Control Programme, Ghana Health Service, Korle-Bu, Accra, GhanaCorrespondence: Raphael Adu-GyamfiNational AIDS/STI Control Programme, Ghana Health Service, Korle-bu, Accra, GhanaTel +233267075458Email ralphgyamfi@gmail.comAbstract: Of the 37 million people estimated to be living with HIV globally in 2017, about 24.7 million were in the sub-Saharan Africa region, which has been and remains worst affected by the epidemic. Enrolment of newly diagnosed individuals into care in the region, however, remains poor with up to 54% not being linked to care. Linkage to care is a very important step in the HIV cascade as it is the precursor to initiating antiretroviral therapy (ART), retention in care, and viral suppression. A systematic review was conducted to gather information regarding the strategies that have been documented to increase linkage to care of Persons living with HIV(PLHIV) in urban areas of sub-Saharan Africa. An electronic search was conducted on Scopus, Cochrane central, CINAHL Plus, PubMed and OpenGrey for linkage strategies implemented from 2006. A total of 189 potentially relevant citations were identified, of which 7 were eligible for inclusion. The identified strategies were categorized using themes from literature. The most common strategies included: health system interventions (i.e. comprehensive care, task shifting); patient convenience and accessibility (i.e. immediate CD4 count testing, immediate ART initiation, community HIV testing); behavior interventions and peer support (i.e. assisted partner services, care facilitation, mobile phone appointment reminders, health education) and incentives (i.e. non-cash financial incentives and transport reimbursement). Several strategies showed favorable outcomes: comprehensive care, immediate CD4 count testing, immediate ART initiation, and assisted partner services. Assisted partner services, same day home-based ART initiation, combination intervention strategies and point-of-care CD4 testing significantly improved linkage to care in urban settings of sub-Saharan African region. They can be delivered either in a health facility or in the community but should be facilitated by health workers. There is, however, the need to conduct more linkage-specific studies in the sub-region.Keywords: linkage to care, human immunodeficiency virus, acquired immune deficiency syndrome, urban, sub-Saharan Africa, adultshttps://www.dovepress.com/strategies-to-improve-linkage-to-hiv-care-in-urban-areas-of-sub-sahara-peer-reviewed-article-HIVlinkage to carehuman immunodeficiency virusacquired immune deficiency syndromeurbansub-saharan africaadults |
| spellingShingle | Koduah Owusu K Adu-Gyamfi R Ahmed Z Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review HIV/AIDS: Research and Palliative Care linkage to care human immunodeficiency virus acquired immune deficiency syndrome urban sub-saharan africa adults |
| title | Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review |
| title_full | Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review |
| title_fullStr | Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review |
| title_full_unstemmed | Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review |
| title_short | Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review |
| title_sort | strategies to improve linkage to hiv care in urban areas of sub saharan africa a systematic review |
| topic | linkage to care human immunodeficiency virus acquired immune deficiency syndrome urban sub-saharan africa adults |
| url | https://www.dovepress.com/strategies-to-improve-linkage-to-hiv-care-in-urban-areas-of-sub-sahara-peer-reviewed-article-HIV |
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