دورية أكاديمية
أعرض في EDS

Examining barriers to antiretroviral therapy initiation in infants living with HIV in sub-Saharan Africa despite the availability of point-of-care diagnostic testing: a narrative systematic review.

التفاصيل البيبلوغرافية
العنوان: Examining barriers to antiretroviral therapy initiation in infants living with HIV in sub-Saharan Africa despite the availability of point-of-care diagnostic testing: a narrative systematic review.
المؤلفون: Chapuma CIJ; Malawi Liverpool Research Programme, Blantyre, Malawi.; Kamuzu University of Health Sciences, Blantyre, Malawi., Sakala D; Malawi Liverpool Research Programme, Blantyre, Malawi., Nyang'wa MN; Kamuzu University of Health Sciences, Blantyre, Malawi.; University College London, London, UK., Hosseinipour MC; University of North Carolina Project, Lilongwe, Malawi., Mbeye N; Kamuzu University of Health Sciences, Blantyre, Malawi., Matoga M; University of North Carolina Project, Lilongwe, Malawi., Kumwenda MK; Malawi Liverpool Research Programme, Blantyre, Malawi.; Kamuzu University of Health Sciences, Blantyre, Malawi., Chikweza A; Malawi Liverpool Research Programme, Blantyre, Malawi., Nyondo-Mipando AL; Malawi Liverpool Research Programme, Blantyre, Malawi.; Kamuzu University of Health Sciences, Blantyre, Malawi., Mwapasa V; Kamuzu University of Health Sciences, Blantyre, Malawi.
المصدر: Journal of the International AIDS Society [J Int AIDS Soc] 2024 Jul; Vol. 27 Suppl 1, pp. e26284.
نوع المنشور: Journal Article; Systematic Review; Review
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: Print Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE
أسماء مطبوعة: Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc
Original Publication: [London] : BioMed Central
مواضيع طبية MeSH: HIV Infections*/drug therapy , HIV Infections*/diagnosis , Point-of-Care Testing*, Humans ; Africa South of the Sahara/epidemiology ; Infant ; Anti-Retroviral Agents/therapeutic use ; Infant, Newborn ; Female ; Anti-HIV Agents/therapeutic use ; Infectious Disease Transmission, Vertical/prevention & control ; Health Services Accessibility
مستخلص: Introduction: Antiretroviral therapy (ART) initiation in infants living with HIV before 12 weeks of age can reduce the risk of mortality by 75%. Point-of-care (POC) diagnostic testing is critical for prompt ART initiation; however, despite its availability, rates of ART initiation are still relatively low before 12 weeks of age. This systematic review describes the barriers to ART initiation in infants before 12 weeks of age, despite the availability of POC.
Methods: This systematic review used a narrative synthesis methodology. We searched PubMed and Scopus using search strategies that combined terms of multiple variants of the keywords "early infant initiation on antiretroviral therapy," "barriers" and "sub-Saharan Africa" (initial search 18th January 2023; final search 1st August 2023). We included qualitative, observational and mixed methods studies that reported the influences of early infant initiation on ART. We excluded studies that reported influences on other components of the Prevention of Mother to Child Transmission cascade. Using a deductive approach guided by the updated Consolidated Framework of Implementation Research, we developed descriptive codes and themes around barriers to early infant initiation on ART. We then developed recommendations for interventions for the identified barriers using the action, actor, target and time framework from the codes.
Results: Of the 266 abstracts reviewed, 52 full-text papers were examined, of which 12 papers were included. South Africa had most papers from a single country (n = 3) and the most reported study design was retrospective (n = 6). Delays in ART initiation beyond 12 weeks in infants 0-12 months were primarily associated with health facility and maternal factors. The most prominent barriers identified were inadequate resources for POC testing (including human resources, laboratory facilities and patient follow-up). Maternal-related factors, such as limited male involvement and maternal perceptions of treatment and care, were also influential.
Discussion: We identified structural barriers to ART initiation at the health system, social and cultural levels. Improvements in the timely allocation of resources for POC testing operations, coupled with interventions addressing social and behavioural barriers among both mothers and healthcare providers, hold a promise for enhancing timely ART initiation in infants.
Conclusions: This paper identifies barriers and proposes strategies for timely ART initiation in infants.
(© 2024 The Author(s). Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society.)
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معلومات مُعتمدة: D43TW010060 Fogarty International Center of the National Institutes of Health
فهرسة مساهمة: Keywords: HIV; antiretroviral therapy; diagnosis; infant; point‐of‐care; sub‐Saharan Africa
المشرفين على المادة: 0 (Anti-Retroviral Agents)
0 (Anti-HIV Agents)
تواريخ الأحداث: Date Created: 20240705 Date Completed: 20240705 Latest Revision: 20240708
رمز التحديث: 20240708
مُعرف محوري في PubMed: PMC11224580
DOI: 10.1002/jia2.26284
PMID: 38965987
قاعدة البيانات: MEDLINE
الوصف
تدمد:1758-2652
DOI:10.1002/jia2.26284