Do Community-Based Programs Help to Improve HIV Treatment and Health Outcomes? A Review of the Literature

Abstract

Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are largely dysfunctional, major barriers to achieving this goal remain. While treatments with antiretroviral drugs (ART) are the focal point of HIV management, it is increasingly recognized that ART alone will not be sufficient to adequately deal with the lifelong consequences of the disease. In addition, the current global economic downturn will continue to impact on funding for HIV care and support, making the search for sustainable solutions more urgent. This article reviews the current evidence base on the impact of community-based programs on HIV/AIDS treatment and general health outcomes, as well as their contribution to ensuring sustained care for HIV-positive people. Our findings suggest that these programs overall have a positive impact on various dimensions of HIV treatment and care, and make a significant contribution to health and HIV outcomes. The authors argue that better use of community platforms for HIV treatment and care programs could be critical for attaining desired goals and should be prioritized at all levels of program design, implementation, and monitoring and evaluation.

Funding of community-based interventions for HIV prevention

“…The importance of community responses was acknowledged in the Strategic Investment Framework, published by UNAIDS in 2011, which identified community responses as "critical enablers" (Schwartlander et al, 2011). Their importance for improving adherence and access to treatment and care has recently come to the fore due to a series of impact evaluation studies (Amanyeiwe, Leclerc-Madlala, & Gardi, 2014), and they are viewed as an essential component of UNAIDS' strategy for reaching the Fast-Track Targets (UNAIDS, 2014). Achieving this goal would require community-based services for treatment and care to rise from 3% in 2013 to 30% of all services by 2030;…”