Improved long-term antiretroviral treatment outcomes amongst patients receiving community-based adherence support in South Africa

Fatti, Geoffrey; Mothibi, Eula; Shaikh, Najma; Grimwood, Ashraf

doi:10.1080/09540121.2016.1191605

Cited by 29 publications

(29 citation statements)

References 30 publications

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“…The drop in inequity in ART coverage, mainly among the major regions and regions with huge burden of HIV, can be explained by the improved health systems capacity and the approach that the country has been utilizing to increase primary healthcare (PHC) services [35,36]. In other countries, community-supported models of care, including task shifting to community health workers, have improved HIV testing and treatment [39][40][41]. Providing support, including accompanied clinic visits and money for transportation, and removing user fees greatly increases HIV testing and treatment [42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

et al. 2020

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Background: The third Sustainable Development Goal (SDG − 3) aims to ensure healthy lives and promote wellbeing for all at all ages. SDG-3 has a specific target on universal health coverage (UHC), which emphasizes the importance of all people and communities having access to quality health services without risking financial hardship. The objective of this study is to review progress towards UHC using antiretroviral treatment (ART) as a case study. Methods: We used a mixed-methods design including qualitative and quantitative approaches. We reviewed and synthesised the evidence on the evolution of the WHO HIV treatment guidelines between 2002 and 2019. We calculated ART coverage over time by gender, age group, and location. We also estimated ART coverage differences and ratios. Findings: ART guidelines have evolved from "treating the sickest" to "treating all". ART coverage increased globally from under 7% in 2005 to 62% in 2018. There have been successes in increasing ART coverage in all populations and locations. However, progress varies by population and location in many regions. There is inequity in ART coverage: women (68%) versus men (55%), and adults (62%) versus children (54%). This inequity has widened over time, and with expanded ART eligibility criteria. On the other hand, data from at least one high-burden country (Ethiopia) shows that inequity among regions has narrowed over time due to the improvements in the primary health care systems and implementation of the public health approach in the country. Conclusion: ART coverage has increased at global, regional and national levels to all population groups. However, the gains have not been equitable among locations and populations. Policies towards universality may widen the inequity in resource-limited settings unless countries take precautions and "put the last first". We argue that primary health care and public health approaches, with multi-sectoral actions and community engagement, are vital to minimize inequity, achieve UHC and leave no one behind.

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Section: Discussionmentioning

confidence: 99%

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

et al. 2020

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“…The drop in inequity in ART coverage, mainly among the major regions and regions with huge burden of HIV, can be explained by the improved health systems capacity and the approach that the country has been utilizing to increase primary healthcare (PHC) services [34,35]. In other countries, communitysupported models of care, including task shifting to community health workers, have improved HIV testing and treatment [38][39][40]. Providing support, including accompanied clinic visits and money for transportation, and removing user fees greatly increases HIV testing and treatment [41][42][43].…”

Section: Scaling Up Of Antiretroviral Treatment: Coveragementioning

confidence: 99%

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

Assefa

Hill

Damme

et al. 2019

Preprint

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Background The third Sustainable Development Goal (SDG-3) aims to ensure healthy lives and promote well-being for all at all ages. SDG-3 has a specific target on universal health coverage (UHC), which emphasizes the importance of all people and communities having access to quality health services without risking financial hardship. The objective of this study is to review progress towards UHC using antiretroviral treatment (ART) as a case study.Methods We used a mixed-methods design including qualitative and quantitative approaches. We reviewed and synthesised the evidence on the evolution of the WHO HIV treatment guidelines between 2002 and 2019. We calculated ART coverage over time by gender, age group, and location. We also estimated ART coverage differences and ratios.Findings ART guidelines have evolved from “treating the sickest” to “treating all”. ART coverage increased globally from under 7% in 2005 to 62% in 2018. There have been successes in increasing ART coverage in all populations and locations. However, progress varies by population and location in many regions. There is inequity in ART coverage: women (68%) versus men (55%), and adults (62%) versus children (54%). This inequity has widened over time, and with expanded ART eligibility criteria. On the other hand, data from at least one high-burden country (Ethiopia) shows that inequity among regions has narrowed over time due to the improvements in the primary health care systems and implementation of the public health approach in the country.Conclusion ART coverage has increased at global, regional and national levels to all population groups. However, the gains have not been equitable among locations and populations. Policies towards universality may widen the inequity in resource-limited settings. We argue that primary health care and public health approaches, with multi-sectoral actions, are vital to minimize inequity and achieve UHC.

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“…Expanded ART access led to 3.2 million people being on treatment by the end of 2015. 53 As a result, women's life expectancy rose from 55 years in 2005 to 64 years in 2015, compared to 73 years without AIDS mortality. 53 The introduction of nurse-initiated and managed ART has contributed to the ART expansion and access.…”

Section: Introductionmentioning

confidence: 99%

“…53 As a result, women's life expectancy rose from 55 years in 2005 to 64 years in 2015, compared to 73 years without AIDS mortality. 53 The introduction of nurse-initiated and managed ART has contributed to the ART expansion and access. 54 Fixed-dose, simplified ART regimens and adherence clubs have been shown to promote adherence.…”

Section: Introductionmentioning

confidence: 99%

“…54 Fixed-dose, simplified ART regimens and adherence clubs have been shown to promote adherence. 53 In keeping with WHO guidelines, the Minister of Health announced the introduction of immediate ART initiation for those testing HIV positive ("test and treat") in the public health sector from September 2016. 55 The Health Ministry's target is to test and initiate ART treatment upon diagnosis for an additional 300,000 people per annum from this year.…”

Section: Introductionmentioning

confidence: 99%

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Coming of age? Women’s sexual and reproductive health after twentyone years of democracy in South Africa

Cooper

Harries

Moodley

et al. 2016

Reproductive Health Matters

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This paper is a sequel to a 2004 article that reviewed South Africa's introduction of new sexual and reproductive health (SRH) and rights laws, policies and programmes, a decade into democracy. Similarly to the previous article, this paper focuses on key areas of women's SRH: contraception and fertility, abortion, maternal health, HIV, cervical and breast cancer and sexual violence. In the last decade, South Africa has retained and expanded its sexual and reproductive health and rights (SRHR) policies in the areas of abortion, contraception, youth and HIV treatment (with the largest antiretroviral treatment programme in the world). These are positive examples within the SRHR policy arena. These improvements include fewer unsafe abortions, AIDS deaths and vertical HIV transmission, as well as the public provision of a human papillomavirus vaccine to prevent cervical cancer. However, persistent socio-economic inequities and gender inequality continue to profoundly affect South African women's SRHR. The state shows mixed success over the past two decades in advancing measurable SRH social justice outcomes, and in confronting and ameliorating social norms that undermine SRHR.

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Improved long-term antiretroviral treatment outcomes amongst patients receiving community-based adherence support in South Africa

Cited by 29 publications

References 30 publications

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

Coming of age? Women’s sexual and reproductive health after twentyone years of democracy in South Africa

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