Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.

<h4>Background</h4>Integration of human immunodeficiency virus (HIV) care into primary care services is one strategy proposed to achieve universal access to antiretroviral treatment (ART) for HIV-positive patients in high burden countries. There is a need for controlled studies of progra...

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Autores principales:	Kerry E Uebel, Gina Joubert, Edwin Wouters, Willie F Mollentze, Dingie H C J van Rensburg
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/db92cde75d204cedbd26ff2e615c67ca
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spelling	oai:doaj.org-article:db92cde75d204cedbd26ff2e615c67ca2021-11-18T08:00:38ZIntegrating HIV care into primary care services: quantifying progress of an intervention in South Africa.1932-620310.1371/journal.pone.0054266https://doaj.org/article/db92cde75d204cedbd26ff2e615c67ca2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23349843/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Integration of human immunodeficiency virus (HIV) care into primary care services is one strategy proposed to achieve universal access to antiretroviral treatment (ART) for HIV-positive patients in high burden countries. There is a need for controlled studies of programmes to integrate HIV care with details of the services being integrated.<h4>Methods</h4>A semi-quantitative questionnaire was developed in consultation with clinic staff, tested for internal consistency using Cronbach's alpha coefficients and checked for inter-observer reliability. It was used to conduct four assessments of the integration of HIV care into referring primary care clinics (mainstreaming HIV) and into the work of all nurses within ART clinics (internal integration) and the integration of pre-ART and ART care during the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) trial in South Africa. Mean total integration and four component integration scores at intervention and control clinics were compared using one way analysis of variance (ANOVA). Repeated measures ANOVA was used to analyse changes in scores during the trial.<h4>Results</h4>Cronbach's alpha coefficients for total integration, pre-ART and ART integration and mainstreaming HIV and internal integration scores showed good internal consistency. Mean total integration, mainstreaming HIV and ART integration scores increased significantly at intervention clinics by the third assessment. Mean pre-ART integration scores were almost maximal at the first assessment and showed no further change. There was no change in mean internal integration score.<h4>Conclusion</h4>The questionnaire developed in this study is a valid tool with potential for monitoring integration of HIV care in other settings. The STRETCH trial interventions resulted in increased integration of HIV care, particularly ART care, by providing HIV care at referring primary care clinics, but had no effect on integrating HIV care into the work of all nurses with the ART clinic.Kerry E UebelGina JoubertEdwin WoutersWillie F MollentzeDingie H C J van RensburgPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 1, p e54266 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kerry E Uebel Gina Joubert Edwin Wouters Willie F Mollentze Dingie H C J van Rensburg Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.
description	<h4>Background</h4>Integration of human immunodeficiency virus (HIV) care into primary care services is one strategy proposed to achieve universal access to antiretroviral treatment (ART) for HIV-positive patients in high burden countries. There is a need for controlled studies of programmes to integrate HIV care with details of the services being integrated.<h4>Methods</h4>A semi-quantitative questionnaire was developed in consultation with clinic staff, tested for internal consistency using Cronbach's alpha coefficients and checked for inter-observer reliability. It was used to conduct four assessments of the integration of HIV care into referring primary care clinics (mainstreaming HIV) and into the work of all nurses within ART clinics (internal integration) and the integration of pre-ART and ART care during the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) trial in South Africa. Mean total integration and four component integration scores at intervention and control clinics were compared using one way analysis of variance (ANOVA). Repeated measures ANOVA was used to analyse changes in scores during the trial.<h4>Results</h4>Cronbach's alpha coefficients for total integration, pre-ART and ART integration and mainstreaming HIV and internal integration scores showed good internal consistency. Mean total integration, mainstreaming HIV and ART integration scores increased significantly at intervention clinics by the third assessment. Mean pre-ART integration scores were almost maximal at the first assessment and showed no further change. There was no change in mean internal integration score.<h4>Conclusion</h4>The questionnaire developed in this study is a valid tool with potential for monitoring integration of HIV care in other settings. The STRETCH trial interventions resulted in increased integration of HIV care, particularly ART care, by providing HIV care at referring primary care clinics, but had no effect on integrating HIV care into the work of all nurses with the ART clinic.
format	article
author	Kerry E Uebel Gina Joubert Edwin Wouters Willie F Mollentze Dingie H C J van Rensburg
author_facet	Kerry E Uebel Gina Joubert Edwin Wouters Willie F Mollentze Dingie H C J van Rensburg
author_sort	Kerry E Uebel
title	Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.
title_short	Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.
title_full	Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.
title_fullStr	Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.
title_full_unstemmed	Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.
title_sort	integrating hiv care into primary care services: quantifying progress of an intervention in south africa.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/db92cde75d204cedbd26ff2e615c67ca
work_keys_str_mv	AT kerryeuebel integratinghivcareintoprimarycareservicesquantifyingprogressofaninterventioninsouthafrica AT ginajoubert integratinghivcareintoprimarycareservicesquantifyingprogressofaninterventioninsouthafrica AT edwinwouters integratinghivcareintoprimarycareservicesquantifyingprogressofaninterventioninsouthafrica AT williefmollentze integratinghivcareintoprimarycareservicesquantifyingprogressofaninterventioninsouthafrica AT dingiehcjvanrensburg integratinghivcareintoprimarycareservicesquantifyingprogressofaninterventioninsouthafrica
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Integrating HIV care into primary care services: quantifying progress of an intervention in South Africa.

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