Limitations to Access and Use of Antiretroviral Therapy (ART) Among HIV Positive Persons in Lagos, Nigeria

Obstacles and Proposed Solutions to Effective Antiretroviral Therapy in Resource-Limited Settings

“…Thirty relevant studies were identified, of which 11 were in peerreviewed journals [15][16][17][18][19][20][21][22][23][24][25] and 19 were in conference abstracts. [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The earliest studies included in this review were from 2004, reflecting a greater emphasis on research in this field after major initiatives were undertaken (such as ''3 by 5'' by the WHO and the President's Emergency Plan for AIDS Relief [PEPFAR]) to increase ART access in resource-limited countries.…”

“…[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The earliest studies included in this review were from 2004, reflecting a greater emphasis on research in this field after major initiatives were undertaken (such as ''3 by 5'' by the WHO and the President's Emergency Plan for AIDS Relief [PEPFAR]) to increase ART access in resource-limited countries. Among the 30 studies, 21 were from Africa,* 6 from east/southeast Asia,The data collection methods described in the papers comprised mostly of interviews (22 studies), y surveys (7 studies), 16,27,29,34,39,40,42 review of clinical data (7 studies), 18,20,22,27,31,36,38 and focus-group discussions (6 studies). 21,23,28,32,42,43 Respondents included PLWHA with/without ART (22 studies), z noninfected people including elders, teenagers, and university students (11 studies), § health care workers including nurses, doctors, social workers, laboratory technologists (7 studies), 15,21,25,…”

“…24 Inconsistent supply of drugs and breaks in the supply chain caused interruptions in treatment. 16,30 Although free or discounted ART was available, some respondents claimed difficulty in affording the costs of laboratory testing, which is a prerequisite for the treatment. 17,31,41 Some studies reported an insufficient number of laboratories and poor quality equipment.…”

“…Drugs and routine laboratory monitoring tests should be made more affordable. 16,25 Care facilities can offer credit to patients. 25 2.…”

“…30 5. Long distances to travel to care facilities [15][16][17]31,33,42,44 and long waiting lines, 36 resulting in exhaustion and hunger for patients, particularly in combination with journey times. 23 ART is being offered only at certain clinics which might be inaccessible to a large number of people needing care.…”