Antiretroviral Therapy for Refugees and Internally Displaced Persons: A Call for Equity

Mendelsohn, Joshua; Spiegel, Paul; Schilperoord, Marian; Cornier, Nadine; Ross, David A.

doi:10.1371/journal.pmed.1001643

Cited by 15 publications

(7 citation statements)

References 33 publications

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“…However, in Kenya another study found that recently displaced HIV-positive adults died at higher rates than HIV-positive local resident adults, potentially due to increased exposure to fatal opportunistic infections, as displacement disrupted daily cotrimoxazole prophylaxis treatment for those not yet, or recently started, on therapy ( Feikin et al., 2010 ). As such, IDPs must not be excluded from HIV national strategic plans ( Mendelsohn et al., 2014 ). Indeed, HIV care is possible, even in displacement settings, if planned effectively.…”

Section: Review Findingsmentioning

confidence: 99%

Understanding the health needs of internally displaced persons: A scoping review

Cantor

Swartz

Roberts

et al. 2021

Journal of Migration and Health

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Section: Review Findingsmentioning

confidence: 99%

Understanding the health needs of internally displaced persons: A scoping review

Cantor

Swartz

Roberts

et al. 2021

Journal of Migration and Health

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“…For example, studies have shown that ARV drugs are less accessible for men and children as compared to women (Baltussen et al., 2013 ; Johnson, 2012 ; Tromp et al, 2014 ). Equity in access to ART has also been examined along clinical practices of treating patients on a first-come basis as compared to treating those who are most ill or likely to benefit from treatment (Baltussen et al., 2013 ; Cleary, Mooney, & McIntyre, 2010 ; Kalanda, Makwiza, & Kemp, 2007 ; Mendelsohn, Spiegel, Schilperoord, Cornier, & Ross, 2014 ). Less commonly, HIV equity concerns have also grappled with ARV allocation on the basis of treatment adherence (Kimmel, Daniels, Betancourt, Wood, & Prosser, 2012 ) and the integration of men into home-based HIV/AIDS care (Newman, Fogarty, Makoae, & Reavely, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Equity in adherence to antiretroviral therapy among economically vulnerable adolescents living with HIV in Uganda

et al. 2016

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Studies from sub-Saharan Africa indicate that children made vulnerable by poverty have been disproportionately affected by HIV with many exposed via mother-to-child transmission. For youth living with HIV, adherence to life saving treatment regimens are likely to be affected by the complex set of economic and social circumstances that challenge their families and also exacerbate health problems. Using baseline data from the National Institute of Child and Human Development (NICHD) funded Suubi+Adherence study, we examined the extent to which individual and composite measures of equity predict self-reported adherence among Ugandan adolescents aged 10–16 (n = 702) living with HIV. Results showed that greater asset ownership, specifically familial possession of seven or more tangible assets, was associated with greater odds of self-reported adherence (OR 1.69, 95% CI: 1.00–2.85). Our analyses also indicated that distance to the nearest health clinic impacts youth’s adherence to an ARV regimen. Youth who reported living nearest to a clinic were significantly more likely to report optimal adherence (OR 1.49, 95% CI: 0.92–2.40). Moreover, applying the composite equity scores, we found that adolescents with greater economic advantage in ownership of household assets, financial savings, and caregiver employment had higher odds of adherence by a factor of 1.70 (95% CI: 1.07–2.70). These findings suggest that interventions addressing economic and social inequities may be beneficial to increase ART uptake among economically vulnerable youth, especially in sub-Saharan Africa. This is one of the first studies to address the question of equity in adherence to antiretroviral therapy among economically vulnerable youth with HIV.

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“…Over the past 15 years, HIV programmes have amassed substantial experience delivering effective chronic care to populations with these challenges, in both resource-rich and resource-poor settings. In addition, HIV treatment has been successfully provided to refugees and internally displaced people; a 2014 review noted that 87-99% of forced migrants with HIV had achieved at least 95% adherence and positive treatment outcomes (Mendelsohn, Spiegel, Schilperoord, Cornier, & Ross, 2014). With the appropriate support, HIV treatment outcomes for forced migrants can be similar to that of the host community .…”

Section: Available Services and Systems For Refugeesmentioning

confidence: 99%

Addressing chronic diseases in protracted emergencies: Lessons from HIV for a new health imperative

Rabkin

Fouad

El‐Sadr

2016

Global Public Health

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Forcible displacement has reached unprecedented levels, with more refugees and internally displaced people reported since comprehensive statistics have been collected. The rising numbers of refugees requiring health services, the protracted nature of modern displacement, and the changing demographics of refugee populations have created compelling new health needs and challenges. In addition to the risk of malnutrition, infectious diseases and exposure to the elements attendant upon conflict and the breakdown of public health systems, many displaced people now require continuity care for the prevention and treatment of cardiovascular disease, diabetes, asthma, cancer, and mental health, as well as maternal and child health services. In some regions, most refugee health services need to be provided in dispersed settings within host communities, rather than in traditional refugee camps, and the number of refugees suffering protracted displacement is growing rapidly. These realities highlight a significant disconnect between the health needs of twenty-first century refugees, and the global systems that have been established to address them. The global response to the HIV epidemic offers lessons about ways to support continuity care for chronic conditions during complex emergencies and may provide important blueprints as the global community struggles to redesign refugee health services.

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Antiretroviral Therapy for Refugees and Internally Displaced Persons: A Call for Equity

Cited by 15 publications

References 33 publications

Understanding the health needs of internally displaced persons: A scoping review

Understanding the health needs of internally displaced persons: A scoping review

Equity in adherence to antiretroviral therapy among economically vulnerable adolescents living with HIV in Uganda

Addressing chronic diseases in protracted emergencies: Lessons from HIV for a new health imperative

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