Facilitators and barriers in HIV linkage to care interventions

Abstract

Objective To synthesize qualitative evidence on linkage to care interventions for people living with HIV. Design Systematic literature review. Methods We searched nineteen databases for studies reporting qualitative evidence on linkage interventions. Data extraction and thematic analysis were used to synthesize findings. Quality was assessed using the CASP tool and certainty of evidence was evaluated using the CERQual approach. Results Twenty-five studies from eleven countries focused on adults (24 studies), adolescents (8 studies), and pregnant women (4 studies). Facilitators included community-level factors (i.e. task-shifting, mobile outreach, integrated HIV and primary services, supportive cessation programs for substance users, active referrals, and dedicated case management teams) and individual-level factors (encouragement of peers/family and positive interactions with healthcare providers in transitioning into care). One key barrier for people living with HIV was perceived inability of providers to ensure confidentiality as part of linkage to care interventions. Providers reported difficulties navigating procedures across disparate facilities and having limited resources for linkage to care interventions. Conclusions Our findings extend the literature by highlighting the importance of task-shifting, mobile outreach, and integrated HIV and primary services. Both community and individual level factors may increase the feasibility and acceptability of HIV linkage to care interventions. These findings may inform policies to increase the reach of HIV services available in communities .

Predictors of Mortality among Adult People Living with HIV and Its Implications for Appointment Spacing Model Approach Care in Southwest Ethiopia.

“…The study revealed that mortality was found to be higher among (65.3%). This nding is in line with the national EDHS data (2016) in which the prevalence of HIV infection among females was two times higher than males (50). Studies from African countries also support this nding.…”

“…Hence, two groups who were known to be either exposed or not exposed to the factor of interest in a speci c time frame were compared on the basis of outcomes of interest. The hazard risk is used as measures of estimation of the relative risk (50).…”

Barriers and facilitators of interventions for improving antiretroviral therapy adherence: a systematic review of global qualitative evidence

“…Concerns about loss of confidentiality associated with participating in adherence interventions emerged as a barrier in intervention implementation [15,17,45,54]. It is important to note that this barrier was reported in high income countries (HICs) [45], MIC [15], and LMIC [19,56] settings across the three well-established types of interventions, such as task shifting [15], DOT [45,54] and a mobile phone text message intervention [17]. Adolescents living with HIV and adults reported that participating in interventions could inadvertently reveal their HIV status [15,17,45,54].…”

“…A systematic review of qualitative evidence of interventions for improving ART adherence can help to better understand barriers and facilitators to interventions [18,19]. It is imperative to understand potential participant harms and benefits to more effectively address health equity and human rights [20].…”

Traditional health practitioners’ management of HIV/AIDS in rural South Africa in the era of widespread antiretroviral therapy

“…While large numbers of people are being initiated on ART, several research studies have found that the use of traditional health practitioners (THPs) continues to delay individuals from timeously obtaining care, and remaining in care [24–27]. Furthermore, numerous studies have examined the implications of traditional medicines and practices related to HIV treatment and management [28–31].…”