A people‐centred health system must be the foundation for person‐centred care in the HIV response

Lazarus, Jeffrey V.; Janamnuaysook, Rena; Caswell, Georgina

doi:10.1002/jia2.26125

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…The general care of ageing people living with HIV should consider both HIV‐related and age‐related conditions. A patient‐centred care [8] approach should be considered as the main strategy, as it addresses access to care, emotional support, physical comfort and respect for patient's preferences, among other principles. This model of care requires collaboration between the patient and an interdisciplinary team to facilitate active patient involvement in decision‐making [9].…”

Section: Caring For Ageing People Living With Hivmentioning

confidence: 99%

Tackling ageism in the healthcare system: A community perspective

Policek,

Mendão

2023

HIV Medicine

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Section: Caring For Ageing People Living With Hivmentioning

confidence: 99%

Tackling ageism in the healthcare system: A community perspective

Policek,

Mendão

2023

HIV Medicine

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“…the four S's), over time it became clear that services unresponsive to individual circumstances—even when free of charge—are not always able to adequately engage patients and deliver sustained population health gains. In response, the global public health community has increasingly embraced ideas about patient, person or client‐centredness as a priority for high‐quality, responsive health services [ 2 , 3 , 4 , 5 ]. For example, Differential Service Delivery (DSD) Models that seek to modify the nature, frequency and location of services to minimize unnecessary burdens have been widely championed.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, some domains of patient‐centredness have received much more attention than others. DSD and other delivery models have received more attention than those, as put forth by Scholl, related to provider−patient interaction and patient experience [ 5 , 6 , 7 , 8 , 9 ]. The field also needs to identify the effects of different aspects of patient‐centredness on particular cascade targets (e.g.…”

Section: Introductionmentioning

confidence: 99%

Person‐centred interventions to improve patient−provider relationships for HIV services in low‐ and middle‐income countries: a systematic review

Beres,

Underwood,

Le Tourneau

et al. 2024

J Int AIDS Soc.

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IntroductionPerson‐centred care (PCC) has been recognized as a critical element in delivering quality and responsive health services. The patient−provider relationship, conceptualized at the core of PCC in multiple models, remains largely unexamined in HIV care. We conducted a systematic review to better understand the types of PCC interventions implemented to improve patient−provider interactions and how these interventions have improved HIV care continuum outcomes and person‐reported outcomes (PROs) among people living with HIV in low‐ and middle‐income countries.MethodsWe searched databases, conference proceedings and conducted manual targeted searches to identify randomized trials and observational studies published up to January 2023. The PCC search terms were guided by the Integrative Model of Patient‐Centeredness by Scholl. We included person‐centred interventions aiming to enhance the patient−provider interactions. We included HIV care continuum outcomes and PROs.ResultsWe included 28 unique studies: 18 (64.3%) were quantitative, eight (28.6.%) were mixed methods and two (7.1%) were qualitative. Within PCC patient−provider interventions, we inductively identified five categories of PCC interventions: (1) providing friendly and welcoming services; (2) patient empowerment and improved communication skills (e.g. supporting patient‐led skills such as health literacy and approaches when communicating with a provider); (3) improved individualized counselling and patient‐centred communication (e.g. supporting provider skills such as training on motivational interviewing); (4) audit and feedback; and (5) provider sensitisation to patient experiences and identities. Among the included studies with a comparison arm and effect size reported, 62.5% reported a significant positive effect of the intervention on at least one HIV care continuum outcome, and 100% reported a positive effect of the intervention on at least one of the included PROs.DiscussionAmong published HIV PCC interventions, there is heterogeneity in the components of PCC addressed, the actors involved and the expected outcomes. While results are also heterogeneous across clinical and PROs, there is more evidence for significant improvement in PROs. Further research is necessary to better understand the clinical implications of PCC, with fewer studies measuring linkage or long‐term retention or viral suppression.ConclusionsImproved understanding of PCC domains, mechanisms and consistency of measurement will advance PCC research and implementation.

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“…The delivery of person-centered care (i.e., care that is more responsive to patient’s values, needs, and preferences) is a core component of the HIV response for the 1.2 million women whose pregnancies are impacted by HIV each year. [ 1 , 2 ] In eastern and southern Africa, where half of the pregnant women living with HIV (WLH) reside, studies have predominantly focused on identifying service delivery strategies to improve the prevention of mother-to-child HIV transmission (PMTCT) outcomes. [ 3 ] This is particularly the case for women newly diagnosed with HIV at antenatal clinic (ANC) enrollment, who are at increased risk of care disengagement and HIV viremia.…”

Section: Introductionmentioning

confidence: 99%

Understanding Women’s Preferences for Prevention of Mother-to-Child HIV Transmission Services in Kenya

Humphrey,

Wanjama,

Carlucci

et al. 2024

IJMA

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Background and Objective Understanding the preferences of women living with HIV (WLH) for the prevention of mother-to-child HIV transmission (PMTCT) services is important to ensure such services are person-centered. Methods From April to December 2022, we surveyed pregnant and postpartum WLH enrolled at five health facilities in western Kenya to understand their preferences for PMTCT services. WLH were stratified based on the timing of HIV diagnosis: known HIV-positive (KHP; before antenatal clinic [ANC] enrollment), newly HIV-positive (NHP; on/after ANC enrollment). Multivariable logistic regression was used to determine associations between various service preferences and NHP (vs. KHP) status, controlling for age, facility, gravidity, retention status, and pregnancy status. Results Among 250 participants (median age 31 years, 31% NHP, 69% KHP), 93% preferred integrated versus non-integrated HIV and maternal-child health (MCH) services; 37% preferred male partners attend at least one ANC appointment (vs. no attendance/no preference); 54% preferred support groups (vs. no groups; 96% preferred facility – over community-based groups); and, preferences for groups was lower among NHP (42%) versus KHP (60%). NHP had lower odds of preferring support groups versus KHP (aOR 0.45, 95% CI 0.25–0.82), but not the other services. Conclusion and Global Health Implications Integrated services were highly preferred by WLH, supporting the current PMTCT service model in Kenya. Further research is needed to explore the implementation of facility-based support groups for WLH as well as the reasons underlying women’s preferences.

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A people‐centred health system must be the foundation for person‐centred care in the HIV response

Cited by 7 publications

References 21 publications

Tackling ageism in the healthcare system: A community perspective

Tackling ageism in the healthcare system: A community perspective

Person‐centred interventions to improve patient−provider relationships for HIV services in low‐ and middle‐income countries: a systematic review

Understanding Women’s Preferences for Prevention of Mother-to-Child HIV Transmission Services in Kenya

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