scholarly journals Community-based strategies to strengthen men’s engagement in the HIV care cascade in sub-Saharan Africa

PLoS Medicine ◽  
2017 ◽  
Vol 14 (4) ◽  
pp. e1002262 ◽  
Author(s):  
Monisha Sharma ◽  
Ruanne V. Barnabas ◽  
Connie Celum
Keyword(s):  
Sub Saharan Africa ◽  
Hiv Care ◽  
Community Based ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Sub Saharan

scholarly journals Strategies for retention of heterosexual men in HIV care in sub-Saharan Africa: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246471
Author(s):  
Sylvia Kusemererwa ◽  
Dickens Akena ◽  
Damalie Nakanjako ◽  
Joanita Kigozi ◽  
Regina Nanyunja ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Hiv Care ◽  
Heterosexual Men ◽  
Inclusion Criteria ◽  
Community Based ◽  
Art Programs ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Retention In Hiv Care ◽  
Sub Saharan

Expansion of Antiretroviral Therapy (ART) programs in sub-Saharan Africa (SSA) has increased the number of people accessing treatment. However, the number of males accessing and being retained along the human immunodeficiency virus (HIV) care cascade is significantly below the UNAIDS target. Male gender has been associated with poor retention in HIV care programs, and little is known about strategies that reduce attrition of men in ART programs. This review aimed to summarize any studies on strategies to improve retention of heterosexual males in HIV care in SSA. An electronic search was conducted through Ovid® for three databases (MEDLINE®, Embase and Global Health). Studies reporting interventions aimed at improving retention among heterosexual men along the HIV care cascade were reviewed. The inclusion criteria included randomized-controlled trials (RCTs), prospective or retrospective cohort studies that studied adult males (≥15years of age), conducted in SSA and published between January 2005 and April 2019 with an update from 2019 to 2020. The search returned 1958 articles, and 14 studies from eight countries met the inclusion criteria were presented using the PRISMA guidelines. A narrative synthesis was conducted. Six studies explored community-based adherence support groups while three compared use of facility versus community-based delivery models. Three studies measured the effect of national identity cards, disclosure of HIV status, six-monthly clinic visits and distance from the health center. Four studies measured risk of attrition from care using hazard ratios ranging from 1.2–1.8, four studies documented attrition proportions at an average of 40.0% and two studies an average rate of attrition of 43.4/1000PYs. Most (62%) included studies were retrospective cohorts, subject to risk of allocation and outcome assessment bias. A pooled analysis was not performed because of heterogeneity of studies and outcome definitions. No studies have explored heterosexual male- centered interventions in HIV care. However, in included studies that explored retention in both males and females, there were high rates of attrition in males. More male-centered interventions need to be studied preferably in RCTs. Registry number: PROSPERO2020 CRD42020142923 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020142923.

scholarly journals Effect of Female Sex Work Targeted Community-based Interventions Along the HIV Treatment Cascade in Sub-Saharan Africa: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Lydia Atuhaire ◽  
Olatunji Adetokunboh ◽  
Constance Shumba ◽  
Peter S Nyasulu
Keyword(s):  
Hiv Testing ◽  
Meta Analysis ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Community Based Interventions ◽  
Community Based ◽  
Hiv Services ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Sub Saharan

Abstract Background: Female Sex Workers are extremely vulnerable and highly susceptibility to being infected with human immunodeficiency virus. As a result, community based targeted interventions have been recommended as one of the models of care to improve access to HIV services and continued engagement in care. However little is known about the specific community intervention packages that have optimal effect on FSWs access and retention in HIV care. This paper synthesized evidence on the effectiveness of community-based interventions that provided HIV services to FSWs across all stages of HIV care cascade.Methods: We defined the 5 steps that make up the HIV care cascade and categorized them as outcomes, namely HIV testing, HIV diagnosis, linkage to care, ART use and viral suppression. We conducted a systematic search of randomized controlled trials, cohort and cross sectional studies done in sub-Saharan African countries and published from 2004 to 2020. We reviewed studies with data on the implementation of community interventions for any of the HIV care cascade stage. The data were analyzed using random effects meta-analysis where possible and for the rest of the studies, data were synthesized using summary statistics. Results: The significant impact of the community interventions was observed on HIV testing, HIV diagnosis and ART use. However, for HIV testing and ART use, the improvement was not sustained for the entire period of implementation. There were minimal interventions that had impact on HIV diagnosis, with only one community service delivery model showing significance. Generally, the interventions that had reasonable impact are those that implemented targeted and comprehensive package of HIV services provided at one location, and with unique strategies specific to each cascade stage.Conclusions: The effect of community-based interventions varies across the different stages of HIV care cascade with impact observed in specific strategies with features unique to each cascade stage. Moreover, positive effects of these strategies were short term and with small-scale implementation. As such, the information on long-term treatment outcomes, and the extent to which FSWs remain engaged in care is sparse. There is need to conduct a further research to deepen the assessment of the effectiveness of community-based interventions on HIV care cascade for FSWs. This will enhance identification of evidence based optimal interventions that will guide effective allocation of scarce resources for strategies that would have a significant impact on HIV service delivery.Systematic review registration: PROSPERO CRD42020157623.

scholarly journals The HIV care cascade in sub‐Saharan Africa: systematic review of published criteria and definitions

2021 ◽  
Vol 24 (7) ◽  
Author(s):  
Catrina Mugglin ◽  
Delia Kläger ◽  
Aysel Gueler ◽  
Fiona Vanobberghen ◽  
Brian Rice ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Sub Saharan

scholarly journals HIV Care Cascade Among Adolescents in a “Test and Treat” Community-Based Intervention: HPTN 071 (PopART) for Youth Study

2020 ◽  
Author(s):  
Kwame Shanaube ◽  
David Macleod ◽  
Mwate Joseph Chaila ◽  
Constance Mackworth-Young ◽  
Graeme Hoddinott ◽  
...  
Keyword(s):  
Hiv Care ◽  
Community Based ◽  
Test And Treat ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Youth Study

scholarly journals Mandatory HIV screening, migration and HIV stigma in Canada: exploring the experiences of sub-Saharan African immigrants living with HIV in western Canada

2020 ◽  
Vol 40 (2) ◽  
pp. 38-46
Author(s):  
Aniela dela Cruz ◽  
San Patten ◽  
Inusa Abdulmalik ◽  
Jean Harrowing ◽  
Marc Hall ◽  
...  
Keyword(s):  
Qualitative Data ◽  
Hiv Stigma ◽  
Hiv Care ◽  
Hiv Screening ◽  
Canadian Province ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Canadian Immigration ◽  
Sub Saharan ◽  
Living With Hiv

Introduction In this mixed-methods pilot study, we examined the intersections of the current Canadian immigration policy, mandatory HIV screening during the Immigration Medical Exam (IME) and enacted and internalized stigma for HIV-positive immigrants from sub-Saharan Africa (SSA) in a western Canadian province. We focus on qualitative findings from this study. Methods Using the Internalized HIV Stigma Scale (IHSS), we collected data from eight immigrants from SSA living with HIV in a western Canadian province. We then conducted semistructured interviews with seven of the eight participants. Due to the small sample size, survey data were summarized using descriptive analysis. Qualitative data were analyzed through constant comparative analysis. Results The following key themes emerged from analysis of qualitative data: experiences of HIV-related emotional distress during the IME; varied experiences of HIV testing during the IME; and inconsistent patterns of linkage to medical care, psychosocial supports and engagement in the HIV care cascade. Conclusion Findings from this pilot study cannot be generalized to the broader population of immigrants living with HIV in Canada. However, we found that the experiences of internalized HIV stigma and enacted stigma during the IME potentially influence the long-term engagement in the HIV care cascade during the process of migration and settlement in Canada. Further study in this population is recommended to examine the intersections of current mandatory HIV screening process during the Canadian immigration process, migration, settlement, culture, stigma and engagement in the HIV care cascade.

scholarly journals Impact of Traditional Healers on the HIV Care Cascade in Senegal, West Africa: A Longitudinal Study

2021 ◽  
Author(s):  
Noelle A. Benzekri ◽  
Jacques F. Sambou ◽  
Sanou Ndong ◽  
Mouhamadou Baïla Diallo ◽  
Ibrahima Tito Tamba ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Traditional Healers ◽  
Cd4 Count ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Cascade ◽  
Art Initiation ◽  
Care Cascade ◽  
Prospective Longitudinal

Consultation with traditional healers (THs) is common among people living with HIV in sub-Saharan Africa. We conducted a prospective longitudinal study to determine the association between consultation with THs and HIV outcomes following 12 months of antiretroviral therapy (ART). HIV-infected individuals presenting for care and initiation of ART in Dakar and Ziguinchor, Senegal were eligible for enrollment. Data were collected using interviews, clinical evaluations, laboratory analyses, and chart reviews at enrollment, 6 months after ART initiation, and 12 months after ART initiation. Among the 186 participants, 35.5% consulted a TH. The most common reason for consulting a TH was “mystical” concerns (18%). Those who consulted a TH before ART initiation were more likely to present with a CD4 count < 200 cells/mm3 (44% versus 28%; P = 0.04) and WHO stage 3 or 4 disease (64% versus 46%; P = 0.03), and they were less likely to disclose their HIV status (44% versus 65%; P = 0.04). Those who consulted a TH more than 6 months after ART initiation were more likely to report poor adherence to ART (57% versus 4%; P < 0.01). The strongest predictor of virologic failure was consulting a TH more than 6 months after ART initiation (odd ratio [OR], 7.43; 95% CI, 1.22–45.24). The strongest predictors of mortality were consulting a TH before ART initiation (OR, 3.53; 95% CI, 1.25–9.94) and baseline CD4 count < 200 cells/mm3 (OR, 3.15; 95% CI, 1.12–8.89). Our findings reveal multiple opportunities to strengthen the HIV care cascade through partnerships between THs and biomedical providers. Future studies to evaluate the impact of these strategies on HIV outcomes are warranted.

scholarly journals Differences between migrants and Spanish-born population through the HIV care cascade, Catalonia: an analysis using multiple data sources

2017 ◽  
Vol 145 (8) ◽  
pp. 1670-1681 ◽  
Author(s):  
J. REYES-URUEÑA ◽  
C. CAMPBELL ◽  
C. HERNANDO ◽  
N. VIVES ◽  
C. FOLCH ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Testing ◽  
Sub Saharan Africa ◽  
Retention Rates ◽  
Hiv Care ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Barriers To Access ◽  
Hiv Testing Services ◽  
Shared Risk

SUMMARYMigrants are considered a key group at risk for HIV infection. This study describes differences between migrants and the Spanish-born population as they progress through the HIV care cascade in Catalonia, Spain. This study found that among people reached by prevention activities, migrants had a higher number of barriers to access HIV testing services than Spanish-born people, driven primarily by shared risk factors. Between 2001 and 2013, 9829 new HIV diagnoses were reported in Catalonia, the proportion of migrants increasing from 24% in 2001 to 41% in 2013. Compared with Spanish-born people, migrants had a higher proportion of women at diagnosis (24·6% vs. 16·7%), and were younger (median age of 33 vs. 37). The most frequent at-risk population was MSM (men who have sex with men) in both migrants and Spanish-born people, (40% and 43%, respectively), although there were significant differences by region of origin. People from sub-Saharan Africa had the highest proportion of late diagnosis (63·7%). Compared with the Spanish-born population, migrants on follow-up had a lower proportion of people on antiretroviral therapy (ART) (93·7% vs. 90·8%, P < 0·001) and with viral suppression (87·2% vs. 82·9%, P < 0·001). Migrants have higher number of barriers to access HIV testing services, lower retention rates and proportions on ART as compared with Spanish-born people, these differences not being uniform between migrants from different regions.

scholarly journals SARS-CoV-2 and HIV: Convergence of Two Pandemics in the Caribbean

2020 ◽  
Vol 3 ◽  
Author(s):  
Robert Paulino-Ramirez
Keyword(s):  
Hiv Transmission ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Caribbean Region ◽  
Community Based ◽  
Self Testing ◽  
The Social ◽  
Timely Access ◽  
The Caribbean ◽  
Sub Saharan

This article describes the social, biological, and programmatic interactions between HIV and SARS-CoV-2 co-infections in The Caribbean region. The country islands represent the second most affected region by HIV/AIDS after Sub-Saharan Africa. After the first confirmed COVID-19 cases in the region, it is necessary to reinvent the programmatic interventions designed to eliminate HIV transmission, and implement innovative interventions that are not yet currently available like PrEP, HIV self-testing, and multiple medication dispensing. COVID-19 pandemic offers an opportunity to governments, community-based organizations, and international partners to maintain the HIV care continuum, with particular efforts made to ensure timely access to, and to avoid disruption of routinely HIV services.

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