Adaptation of a general primary care package for <scp>HIV</scp>‐infected adults to an <scp>HIV</scp> centre setting in <scp>G</scp>aborone, <scp>B</scp>otswana

Davis, Stephanie M.; Patel, Premal A.; Sheikh, A; Anabwani, Gabriel; Tolle, Michael A.

doi:10.1111/tmi.12041

Cited by 9 publications

(21 citation statements)

References 58 publications

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“…However, the potential benefits of an integrated approach to medical care for PLWH in SSA and other resource-limited settings could be profound, and support for this approach has been fast-growing [ 20 , 124 – 126 ]. The established and expanding HIV infrastructure could be an ideal foundation on which to build additional interventions and management strategies for other chronic diseases [ 29 , 127 ].…”

Section: Discussionmentioning

confidence: 99%

The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review

et al. 2017

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BackgroundSub-Saharan Africa (SSA) has confronted decades of the HIV epidemic with substantial improvements in access to life-saving antiretroviral therapy (ART). Now, with improved survival, people living with HIV (PLWH) are at increased risk for non-communicable diseases (NCDs), including atherosclerotic cardiovascular disease (CVD). We assessed the existing literature regarding the association of CVD outcomes and HIV in SSA.MethodsWe used the PRISMA guidelines to perform a systematic review of the published literature regarding the association of CVD and HIV in SSA with a focus on CVD surrogate and clinical outcomes in PLWH.ResultsFrom January 2000 until March 2017, 31 articles were published regarding CVD outcomes among PLWH in SSA. Data from surrogate CVD outcomes (n = 13) suggest an increased risk of CVD events among PLWH in SSA. Although acute coronary syndrome is reported infrequently in SSA among PLWH, limited data from five studies suggest extensive thrombus and hypercoagulability as contributing factors. Additional studies suggest an increased risk of stroke among PLWH (n = 13); however, most data are from immunosuppressed ART-naïve PLWH and thus are potentially confounded by the possibility of central nervous system infections.ConclusionsGiven ongoing gaps in our current understanding of CVD and other NCDs in PLWH in SSA, it is imperative to ascertain the burden of CVD outcomes, and to examine strategies for intervention and best practices to enhance the health of this vulnerable population.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4940-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review

et al. 2017

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“…Additionally, only 5% of selected studies (n = 1) was a randomized controlled trial (RCT)—a pragmatic cluster RCT [19]. Most studies were either descriptive, cross sectional studies (n = 8) [20, 21, 22, 23, 24, 25, 26, 27] or observational cohort studies (n = 6) [21, 28, 29, 30, 31] (See S1 Dataset )…”

Section: Resultsmentioning

confidence: 99%

“…Of the 20 studies that were included after full-text review, only four studies conducted feasibility studies of an integrated CVD and HIV care intervention (See Table 2 ). Most of the studies (n = 16) reported on feasibility of integrated CVD-HIV care interventions in summary text with statements such as: the intervention ‘is feasible…’ [19, 20, 21, 22] ‘…can be utilized’ [28], and ‘ … can increase healthcare access’ [32] (See Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Reporting of feasibility catered to the settings and/or scale-up of the interventions, helping identify unique facilitators and barriers to implementing integrated CVD-HIV care interventions (screening, referral/linkage to care and treatment) in LMIC settings. Barriers include lack of tracking of linkage to care after cases are referred (setting and scale-up specific) [22, 24, 29] loss to follow-up (setting-specific) [20], lacking time to make clinic visits during the weekdays (setting-specific) [30], using non-standard BP cutoffs (setting-specific) [33], insufficient funding (setting and scale-up specific) [28], cumbersome curriculum for training (scale-up specific) [19], and challenges in staffing and equipment (setting-specific) [37].…”

Section: Resultsmentioning

confidence: 99%

“…Facilitators include use of existing trained staff, training of healthcare personnel, use of local leaders (setting and scale-up specific) [22, 26, 28], free-of -charge care (setting-specific) [30], continuous medical supervision (setting-specific) [31], broad acceptability of intervention components (setting-specific) [29], having patient feedback (setting-specific) [29], enthusiastic buy-in, adoption, and acceptability from policy makers (scale-up specific) [19].…”

Section: Resultsmentioning

confidence: 99%

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Feasibility of integrated, multilevel care for cardiovascular diseases (CVD) and HIV in low- and middle-income countries (LMICs): A scoping review

et al. 2019

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Background Integrated cardiovascular disease (CVD) and HIV (CVD-HIV) care interventions are being adopted to tackle the growing burden of noncommunicable diseases (NCDs) in low-and middle-income countries (LMICs) but there is a paucity of studies on the feasibility of these interventions in LMICs. This scoping review aims to present evidence of the feasibility of integrated CVD-HIV care in LMICs, and the alignment of feasibility reporting in LMICs with the existing implementation science methodology. Methods A systematic search of published articles including systematic and narrative reviews that reported on integrated CVD-HIV care was conducted, using multiple search engines including PubMed/Medline, Global Health, and Web of Science. We examined the articles for evidence of feasibility reporting. Adopting the definition of Proctor and colleagues (2011), feasibility was defined as the extent to which an intervention was plausible in a given agency or setting. Evidence from the articles was synthesized by level of integration, the chronic care continuum, and stages of intervention development. Results Twenty studies, reported in 18 articles and 3 conferences abstracts, reported on feasibility of integrated CVD-HIV care interventions. These studies were conducted in Sub-Saharan Africa, Southeast Asia and South America. Four of these studies were conducted as feasibility studies. Eighty percent of the studies reported feasibility, using descriptive sentences that included words synonymous with feasibility terminologies in existing definition recommended by Proctor and colleagues. There was also an overlap in the use of descriptive phrases for feasibility amongst the selected studies. Conclusions Integrating CVD and HIV care is feasible in LMICs, although methodology for reporting feasibility is inconsistent. Assessing feasibility based on settings and integration goals will provide a unique perspective of the implementation landscape in LMICs. There is a need for consistency in measures in order to accurately assess the feasibility of integrated CVD-HIV care in LMICs.

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HIV, Tuberculosis, and Noncommunicable Diseases

Hyle

Naidoo

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Unprecedented investments in health systems low- and middle-income countries (LMICs) have resulted in more than eight million individuals on antiretroviral therapy (ART). Such individuals experience dramatically increased survival, but are increasingly at risk of developing common non-communicable diseases (NCDs). Integrating clinical care for HIV, other infectious diseases, and NCDs could make health services more effective and provide greater value. Cost-effectiveness analysis is a method to evaluate the clinical benefits and costs associated with different healthcare interventions and offers guidance for prioritization of investments and scale-up, especially as resources are increasingly constrained. We first examine tuberculosis and HIV as one example of integrated care already successfully implemented in several LMICs; we then review the published literature regarding cervical cancer and depression as two examples of NCDs for which integrating care with HIV services could offer excellent value. Direct evidence of the benefits of integrated services generally remains scarce; however, data suggest that improved effectiveness and reduced costs may be attained by integrating additional services with existing HIV clinical care. Further investigation into clinical outcomes and costs of care for NCDs among people living with HIV (PLHIV) in LMICs will help to prioritize specific healthcare services by contributing to an understanding of the affordability and implementation of an integrated approach.

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Adaptation of a general primary care package for HIV‐infected adults to an HIV centre setting in Gaborone, Botswana

Cited by 9 publications

References 58 publications

The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review

The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review

Feasibility of integrated, multilevel care for cardiovascular diseases (CVD) and HIV in low- and middle-income countries (LMICs): A scoping review

HIV, Tuberculosis, and Noncommunicable Diseases

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