Cascade of care for HIV-seroconverters in rural Tanzania: a longitudinal study

Colombe, Soledad; Machemba, Richard; Mtenga, Baltazar; Lutonja, Peter; Safari, Wende Clarence; Beard, James; Downs, Jennifer A.; Urassa, Mark; Todd, Jim; Changalucha, John

doi:10.1080/09540121.2019.1640842

Cited by 4 publications

(8 citation statements)

References 11 publications

(13 reference statements)

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“…Thirty‐nine studies reported on initiation of ART [2,21,23,28,33,34,37,40‐42,44‐47,49‐54,23,55‐62,64,66,67‐75], with 25 (64%) defining numerators and denominators. Thirty‐two were longitudinal, four of mixed design and three were cross‐sectional.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐four [ 20 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ] studies reported on people diagnosed with HIV and aware of their status, with 19 providing definitions for the denominator and numerator. Ten were cross‐sectional, 10 longitudinal and 4 included longitudinal and cross‐sectional components (mixed design).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐eight studies reported on this step [ 20 , 23 , 24 , 26 , 27 , 28 , 31 , 33 , 34 , 35 , 37 , 38 , 39 , 41 , 44 , 45 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]: 15 cohort studies, 10 cross‐sectional and three of mixed design. Twenty‐four studies (86%) provided a clear definition of the step (Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐nine studies reported on initiation of ART [ 2 , 21 , 23 , 28 , 33 , 34 , 37 , 40 , 41 , 42 , 44 , 45 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ], with 25 (64%) defining numerators and denominators. Thirty‐two were longitudinal, four of mixed design and three were cross‐sectional.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-eight studies reported on this step [20,23,24,[26][27][28]31,[33][34][35][37][38][39]41,44,45,[47][48][49][50][51][52][53][54][55][56][57][58]: 15 cohort studies, 10 crosssectional and three of mixed design. Twenty-four studies (86%) provided a clear definition of the step (Table 2).…”

Section: Linkage To Pre-art Carementioning

confidence: 99%

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The HIV care cascade in sub‐Saharan Africa: systematic review of published criteria and definitions

et al. 2021

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Introduction:The HIV care cascade examines the attrition of people living with HIV from diagnosis to the use of antiretroviral therapy (ART) and suppression of viral replication. We reviewed the literature from sub-Saharan Africa to assess the definitions used for the different steps in the HIV care cascade. Methods: We searched PubMed, Embase and CINAHL for articles published from January 2004 to December 2020. Longitudinal and cross-sectional studies were included if they reported on at least one step of the UNAIDS 90-90-90 cascade or two steps of an extended 7-step cascade. A step was clearly defined if authors reported definitions for numerator and denominator, including the description of the eligible population and methods of assessment or measurement. The review protocol has been published and registered in Prospero. Results and discussion: Overall, 3364 articles were screened, and 82 studies from 19 countries met the inclusion criteria. Most studies were from Southern (38 studies, 34 from South Africa) and East Africa (29 studies). Fifty-eight studies (71.6%) were longitudinal, with a median follow-up of three years. The medium number of steps covered out of 7 steps was 3 (interquartile range [IQR] 2 to 4); the median year of publication was 2015 (IQR 2013(IQR to 2019. The number of different definitions for the numerators ranged from four definitions (for step "People living with HIV") to 21 (step "Viral suppression"). For the denominators, it ranged from three definitions ("Diagnosed and aware of HIV status") to 14 ("Viral suppression"). Only 12 studies assessed all three of the 90-90-90 steps. Most studies used longitudinal data, but denominator-denominator or denominator-numerator linkages over several steps were rare. Also, cascade data are lacking for many countries. Our review covers the academic literature but did not consider other data, such as government reports on the HIV care cascade. Also, it did not examine disengagement and reengagement in care. Conclusions: The proportions of patients retained at each step of the HIV care cascade cannot be compared between studies, countries and time periods, nor meta-analysed, due to the many different definitions used for numerators and denominators. There is a need for standardization of methods and definitions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Linkage To Pre-art Carementioning

confidence: 99%

See 3 more Smart Citations

The HIV care cascade in sub‐Saharan Africa: systematic review of published criteria and definitions

et al. 2021

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Men missing from the HIV care continuum in sub‐Saharan Africa: a meta‐analysis and meta‐synthesis

et al. 2022

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Introduction:Men are missing along the HIV care continuum. However, the estimated proportions of men in sub-Saharan Africa meeting the UNAIDS 95-95-95 goals vary substantially between studies. We sought to estimate proportions of men meeting each of the 95-95-95 goals across studies in sub-Saharan Africa, describe heterogeneity, and summarize qualitative evidence on factors influencing care engagement. Methods: We systematically searched PubMed and Embase for peer-reviewed articles published between 1 January 2014 and 16 October 2020. We included studies involving men ≥15 years old, with data from 2009 onward, reporting on at least one 95-95-95 goal in sub-Saharan Africa. We estimated pooled proportions of men meeting these goals using DerSimonion-Laird random effects models, stratifying by study population (e.g. studies focusing exclusively on men who have sex with men vs. studies that did not), facility setting (healthcare vs. community site), region (eastern/southern Africa vs. western/central Africa), outcome measurement (e.g. threshold for viral load suppression), median year of data collection (before vs. during or after 2017) and quality criteria. Data from qualitative studies exploring barriers to men's HIV care engagement were summarized using meta-synthesis. Results and discussion: We screened 14,896 studies and included 129 studies in the meta-analysis, compiling data over the data collection period. Forty-seven studies reported data on knowledge of serostatus, 43 studies reported on antiretroviral therapy use and 74 studies reported on viral suppression. Approximately half of men with HIV reported not knowing their status (0.49 [95% CI, 0.41-0.58; range, 0.09-0.97]) or not being on treatment (0.58 [95% CI, 0.51-0.65; range, 0.07-0.97]), while over three-quarters of men achieved viral suppression on treatment (0.79 [95% CI, 0.77-0.81; range, 0.39-0.97]. Heterogeneity was high, with variation in estimates across study populations, settings and outcomes. The meta-synthesis of 40 studies identified three primary domains in which men described risks associated with engagement in HIV care: perceived social norms, health system challenges and poverty. Conclusions: Psychosocial and systems-level interventions that change men's perceptions of social norms, improve trust in and accessibility of the health system, and address costs of accessing care are needed to better engage men, especially in HIV testing and treatment.

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The care cascade of chronic obstructive pulmonary disease in China: a cross-sectional study of individual-level data at enrolment into the national ‘Happy Breathing’ Programme

Wang,

Qi,

Yang

et al. 2024

eClinicalMedicine

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Cascade of care for HIV-seroconverters in rural Tanzania: a longitudinal study

Cited by 4 publications

References 11 publications

The HIV care cascade in sub‐Saharan Africa: systematic review of published criteria and definitions

The HIV care cascade in sub‐Saharan Africa: systematic review of published criteria and definitions

Men missing from the HIV care continuum in sub‐Saharan Africa: a meta‐analysis and meta‐synthesis

The care cascade of chronic obstructive pulmonary disease in China: a cross-sectional study of individual-level data at enrolment into the national ‘Happy Breathing’ Programme

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