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dc.contributor.authorNachega, JB
dc.contributor.authorAdetokunboh, O
dc.contributor.authorUthman, OA
dc.contributor.authorKnowlton, AW
dc.contributor.authorAltice, FL
dc.contributor.authorSchechter, M
dc.contributor.authorGalárraga, O
dc.contributor.authorGeng, E
dc.contributor.authorPeltzer, K
dc.contributor.authorChang, LW
dc.contributor.authorVan Cutsem, G
dc.contributor.authorJaffar, SS
dc.contributor.authorFord, N
dc.contributor.authorMellins, CA
dc.contributor.authorRemien, RH
dc.contributor.authorMills, EJ
dc.date.accessioned2017-02-22T17:34:49Z
dc.date.available2017-02-22T17:34:49Z
dc.date.issued2016-07-30
dc.identifier.citationCommunity-Based Interventions to Improve and Sustain Antiretroviral Therapy Adherence, Retention in HIV Care and Clinical Outcomes in Low- and Middle-Income Countries for Achieving the UNAIDS 90-90-90 Targets. 2016: Curr HIV/AIDS Repen
dc.identifier.issn1548-3576
dc.identifier.pmid27475643
dc.identifier.doi10.1007/s11904-016-0325-9
dc.identifier.urihttp://hdl.handle.net/10144/618801
dc.descriptionWe regret that this article is behind a paywall.en
dc.description.abstractLittle is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low- and middle-income countries (LMICs). We systematically searched four electronic databases for all available randomized controlled trials (RCTs) and comparative cohort studies in LMICs comparing community versus health facility-based interventions. Relative risks (RRs) for pre-defined adherence, treatment engagement (linkage and retention in care), and relevant clinical outcomes were pooled using random effect models. Eleven cohort studies and eleven RCTs (N = 97,657) were included. Meta-analysis of the included RCTs comparing community- versus health facility-based interventions found comparable outcomes in terms of ART adherence (RR = 1.02, 95 % CI 0.99 to 1.04), virologic suppression (RR = 1.00, 95 % CI 0.98 to 1.03), and all-cause mortality (RR = 0.93, 95 % CI 0.73 to 1.18). The result of pooled analysis from the RCTs (RR = 1.03, 95 % CI 1.01 to 1.06) and cohort studies (RR = 1.09, 95 % CI 1.03 to 1.15) found that participants assigned to community-based interventions had statistically significantly higher rates of treatment engagement. Two studies found community-based ART delivery model either cost-saving or cost-effective. Community- versus facility-based models of ART delivery resulted in at least comparable outcomes for clinically stable HIV-infected patients on treatment in LMICs and are likely to be cost-effective.
dc.languageENG
dc.language.isoenen
dc.publisherSpringer Linken
dc.titleCommunity-Based Interventions to Improve and Sustain Antiretroviral Therapy Adherence, Retention in HIV Care and Clinical Outcomes in Low- and Middle-Income Countries for Achieving the UNAIDS 90-90-90 Targetsen
dc.identifier.journalCurrent HIV/AIDS Reportsen
dc.internal.reviewer-noteCurrent HIV/AIDS Reports - Springeren
refterms.dateFOA2019-03-04T13:11:40Z
html.description.abstractLittle is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low- and middle-income countries (LMICs). We systematically searched four electronic databases for all available randomized controlled trials (RCTs) and comparative cohort studies in LMICs comparing community versus health facility-based interventions. Relative risks (RRs) for pre-defined adherence, treatment engagement (linkage and retention in care), and relevant clinical outcomes were pooled using random effect models. Eleven cohort studies and eleven RCTs (N = 97,657) were included. Meta-analysis of the included RCTs comparing community- versus health facility-based interventions found comparable outcomes in terms of ART adherence (RR = 1.02, 95 % CI 0.99 to 1.04), virologic suppression (RR = 1.00, 95 % CI 0.98 to 1.03), and all-cause mortality (RR = 0.93, 95 % CI 0.73 to 1.18). The result of pooled analysis from the RCTs (RR = 1.03, 95 % CI 1.01 to 1.06) and cohort studies (RR = 1.09, 95 % CI 1.03 to 1.15) found that participants assigned to community-based interventions had statistically significantly higher rates of treatment engagement. Two studies found community-based ART delivery model either cost-saving or cost-effective. Community- versus facility-based models of ART delivery resulted in at least comparable outcomes for clinically stable HIV-infected patients on treatment in LMICs and are likely to be cost-effective.


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