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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Autores principales:	Koduah Owusu K, Adu-Gyamfi R, Ahmed Z
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	linkage to care human immunodeficiency virus acquired immune deficiency syndrome urban sub-saharan africa adults Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/804f068689a5459cb725afbe077147b2
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spelling	oai:doaj.org-article:804f068689a5459cb725afbe077147b22021-12-02T03:27:33ZStrategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review1179-1373https://doaj.org/article/804f068689a5459cb725afbe077147b22019-12-01T00:00:00Zhttps://www.dovepress.com/strategies-to-improve-linkage-to-hiv-care-in-urban-areas-of-sub-sahara-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Kwadwo 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, adultsKoduah Owusu KAdu-Gyamfi RAhmed ZDove Medical Pressarticlelinkage to carehuman immunodeficiency virusacquired immune deficiency syndromeurbansub-saharan africaadultsImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 11, Pp 321-332 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	linkage to care human immunodeficiency virus acquired immune deficiency syndrome urban sub-saharan africa adults Immunologic diseases. Allergy RC581-607
spellingShingle	linkage to care human immunodeficiency virus acquired immune deficiency syndrome urban sub-saharan africa adults Immunologic diseases. Allergy RC581-607 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
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
format	article
author	Koduah Owusu K Adu-Gyamfi R Ahmed Z
author_facet	Koduah Owusu K Adu-Gyamfi R Ahmed Z
author_sort	Koduah Owusu K
title	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_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_sort	strategies to improve linkage to hiv care in urban areas of sub-saharan africa: a systematic review
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/804f068689a5459cb725afbe077147b2
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Strategies To Improve Linkage To HIV Care In Urban Areas Of Sub-Saharan Africa: A Systematic Review

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