Antiretroviral Treatment

Public Health Care for South African Lesbian, Gay, Bisexual and Transgender People: Health Rights Violations and Accountability Mechanisms

This study aimed to document LGBT people’s experiences in SA public sector health care, including access to HIV counselling, testing and treatment, to analyse to what extend LGBT people’s right to health is actioned. It also investigates strategies for LGBT people to seek resolution and create accountability when experiencing health rights violations. [from abstract]

Emerging Themes for Sensitivity Training Modules of African Healthcare Workers Attending to Men Who Have Sex With Men: A Systematic Review

Sensitivity training of front-line African health care workers (HCWs) attending to men who have sex with men (MSM) is actively promoted through national HIV prevention programming in Kenya.

Accessibility of Antiretroviral Treatment (ART) Services in Nepal

Antiretroviral treatment (ART) services have been proved to be very effective in treatment and prevention of HIV/AIDS worldwide. This paper is aimed at whether ART services in Nepal are accessible to people living with HIV (PLHIV) and also tries to explore some barriers to accessibility of ART services. [from abstract]

A South African Public-Private Partnership HIV Treatment Model: Viability and Success Factors

The increasing number of people requiring HIV treatment in South Africa calls for efficient use of its human
resources for health in order to ensure optimum treatment coverage and outcomes. This paper describes an innovative
public-private partnership model which uses private sector doctors to treat public sector patients and ascertains the
model’s ability to maintain treatment outcomes over time. [from abstract]

Progress, Challenges and Opportunities for HIV Prevention and Control Among High Risk Groups: A Public Health Perspective

There are various socio-cultural issues/obstacles in prevention of HIV-AIDS in high risk group for e.g., gender inequality, power inequalities and male dominance; condom use believed to be in conflict with the cultural importance for procreation; poverty, illiteracy, increase in migrant population and unemployment; poor knowledge and awareness of reproductive and sexual health and sexuality; emergence of new urban sub-culture and physical or mental abuse at a young age.

Patient Satisfaction with Task Shifting of Antiretroviral Services in Ethiopia: Implications for Universal Health Coverage

Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have largely ignored the patient perspective, focusing on health outcomes and acceptability to health care providers and regulatory bodies, despite studies worldwide that have shown the significance of patient satisfaction as an indicator of quality.

New Analysis Shows How the Private Sector Can Help Sustain HIV Responses

Recent analysis by the SHOPS project shows that the private health sector could help country governments sustain national HIV responses. SHOPS used national health accounts data to track how HIV funds flow through the health systems in Côte d’Ivoire, Kenya, Malawi, and Namibia, and identified ways that donors and the government can better work with the private health sector. [from introduction]

Integrating Family Planning and Antiretroviral Therapy: A Client-Oriented Service Model

The purpose of this program guide is to assist readers in thinking through a successful and efficient plan for [Family Planning and Antiretroviral Therapy] service integration, but the principles apply for integrating core and additional services, whatever they may be.[adapted from background]

Noninferiority of a Task-Shifting HIV Care and Treatment Model Using Peer Counselors and Nurses Among Ugandan Women Initiated on ART: Evidence From a Randomized Trial

The objective of this study was to assess the non-inferiority of a task-shifting HIV treatment model relying on peer counselors and nurses compared with a physician-centered model among HIV-1-positive women initiated on antiretroviral therapy (ART) at a prevention of mother-to-child transmission clinic in Mulago Hospital, Uganda. [from abstract]

Using a Campaign Approach Among Health Workers to Increase Access to Antiretroviral Therapy for Pregnant HIV-Infected Women in South Africa

This study evaluated a targeted brief antiretroviral (ART) campaign among health workers that used quality improvement health systems approaches to significantly improve access to ART for HIV-infected pregnant women across a large health district in South Africa. [adapted from author]

Spread of PMTCT and ART Better Care Practices through Collaborative Learning in Tanzania

This evaluation aims to describe and analyze peer-to-peer learning among health workers and the spread of better care practices within regions and across regions improve care provided to those needing HIV and AIDS services. [adapted from summary]

Tackling Health Workforce Shortages During Antiretroviral Treatment Scale-Up: Experiences from Ethiopia and Malawi

This article draws on the experience of Malawi and Ethiopia, which have been able to successfully increase their health workforce over a relatively short period, allowing scaling up of antiretroviral treatment. [from abstract]

Excellent Clinical Outcomes and High Retention in Care Among Adults in a Community-Based HIV Treatment Program in Rural Rwanda

This artical reports the clinical and programatic outcomes at 24 months for a cohort of patients enrolled in a community-based anti-retroviral treatment (ART) program in southeastern Rwanda which provided additional measures of support at the community level, including community-based psychosocial support and directly observed ART delivered by community health workers. [adapted from author]

NIMART Rollout to Primary Healthcare Facilities Increases Access to Antiretrovirals in Johannesburg: An Interrupted Time Series Analysis

In this study, decentralisation of anitretroviral treatement (ART) initiation by professional nurses through the Nurse Initiatied Management of Antiretroviral Treatment (NIMART) program was shown to increase ART uptake and reduce workloadat referral facilities, enabling them to concentrate on complicated cases. [adapted from author]

Systematic Review Evaluating the Impact of Task Shifting on Access to Antiretroviral Therapy in Sub-Saharan Africa

This review evaluates whether task shifting of ART initiation and management from physicians to nurses increases access to antiretroviral therapy, the primary purpose cited for the implementation of task shifting policies. [from introduction]

How to Keep ART Patients in Long-Term Care: ART Adherence Club Report and Toolkit

This toolkit is simple model that allows patient groups to collect pre-packed, two-month supplies of treatment from lay health workers either at the clinic or outside of the clinic - whether at a local library or at a fellow patients home. Antiretroviral treatment (ART) adherence clubs give stable adherent HIV patients easier access to their treatment, while unclogging clinics and freeing up scarce nurses and doctors to manage new or at-risk HIV patients. [from publisher]

Human Resources Needs for Universal Access to Antiretroviral Therapy in South Africa: A Time and Motion Study

This article quantifies the number of HIV health workers required to be added to the current HIV workforce to achieve universal access to HIV treatment in South Africa, under different eligibility criteria. [from abstract]

Recall of Lost to Follow-Up Pre-Antiretroviral Therapy Patients in the Eastern Cape: Effect of Mentoring on Patient Care

This study sought to prove that mentoring plays an important role in professional nurse training and support and that recall of lost-to-follow-up patients is feasible and effective in improving ART services in rural settings. [adapted from author]

Treatment Outcomes and Cost-Effectiveness of Shifting Management of Stable ART Patients to Nurses in South Africa: An Observational Cohort

This study evaluated the cost-effectiveness of down-referring stable antiretroviral therapy (ART) patients from a doctor-managed, hospital-based ART clinic to a nurse-managed primary health care facility in Johannesburg, South Africa. [from abstract]

Economic Evaluation of Task-Shifting Approaches to the Dispensing of Anti-Retroviral Therapy

The study aims to compare two task-shifting approaches to the dispensing of anti-retroviral therapy (ART): indirectly supervised pharmacist’s assistants and nurse-based pharmaceutical care models against the standard of care which involves a pharmacist dispensing ART. [adapted from abstract]

Task Shifting of Antiretroviral Treatment from Doctors to Primary-Care Nurses in South Africa (STRETCH): A Pragmatic, Parallel, Cluster-Randomised Trial

This article aimed to assess the effects on mortality, viral suppression, and other health outcomes and quality indicators of program for task shifting of antiretroviral therapy from doctors to nurses, which provides educational outreach training for nurses to initiate and represcribe. [adapted from summary]

Impact of Community-Based Support Services on Antiretroviral Treatment Programme Delivery and Outcomes in Resource-Limited Countries: A Systematic Review

Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment scale-up in high-HIV-prevalence, resource-limited settings. This article report on a systematic review of scientific evidence on the contributory role and function of these forms of community mobilisation. [adapted from abstract]

Implementing Nurse-Initiated and Managed Antiretroviral Treatment (NIMART) in South Africa: A Qualitative Process Evaluation of the STRETCH Trial

The STRETCH (Streamlining Tasks and Roles to Expand Treatment and Care for HIV) progra was an intervention implemented in South Africa to enable nurses providing primary HIV/AIDS care to expand their roles and include aspects of care and treatment usually provided by physicians. The effects of STRETCH on pre-ART mortality, ART provision, and the quality of HIV/ART care were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of factors affecting the implementation of the program. [adapted from abstract]

Health Information Technology for Continuous Quality Improvement of HIV Treatment Programs

This compendium of health information technology (HIT) seeks to inform the implementation of HIT to facilitate continuous quality improvement of antiretroviral therapy programs and improved patient outcomes in low and middle income countries. [from author]

Involving Expert Patients in Antiretroviral Treatment Provision in a Tertiary Referral Hospital HIV Clinic in Malawi

This article describes a task shifing intervention in Malawi where a cadre of expert patients was trained to assist with some of the clinical tasks of antiretroviral (ART) services as a way to fill the gap in the availability of health workers. [adapted from author]

Positive Spill-Over Effects of ART Scale Up on Wider Health Systems Development: Evidence from Ethiopia and Malawi

The impact of HIV-specific funds and programmes on non-HIV-related health services and health systems in genera has been debated extensively. Drawing on evidence from Malawi and Ethiopia, this article analyses the effects of ART scale-up interventions on human resources policies, service delivery and general health outcomes, and explores how synergies can be maximized. [from abstract]

Patient Volume, Human Resource Levels, and Attrition from HIV Treatment Programs in Central Mozambique

Human resource shortages are viewed as one of the primary obstacles to provide effective services to growing patient populations receiving antiretroviral therapy and explanding access further. This article examined the relationship of patient volume, human resource levels, and patient characteristics with attrition from HIV treatment programs in central Mozambique. [adapted from abstract]

Effect of Peer Health Workers on AIDS Care in Rakai, Uganda: a Cluster-Randomized Trial

The authors conducted a cluster randomized trial to assess the effect of community-based peer health workers on AIDS care of adults in Rakai, Uganda. [from abstract]

Community Health Workers and the Response to HIV/AIDS in South Africa: Tensions and Prospects

This paper examines the case of South Africa, where there has been rapid growth of a range of lay workers (home-based carers, lay counselor, DOT supporters etc.) principally in response to an expansion in budgets and programmes for HIV, most recently the rollout of antiretroviral therapy. [from author]

Adherence Support Workers: A Way to Address Human Resource Constraints in Antiretroviral Treatment Programs in the Public Health Setting in Zambia

The objective of this study was to assess the effectiveness of these adherence support workers in adherence counseling, treatment retention for people on antiretroviral therapy and addressing inadequate human resources at health facilities. [from abstract]