One-Stop Shop: A Community-Based Antiretroviral Therapy (ART) Clinic Model to Improve Human Immunodeficiency Virus (HIV) Prevention and Treatment Cascade for Key Populations in Nigeria

Onovo, Amobi; Kalaiwo, Abiye; Okechukwu, Emeka

doi:10.1093/ofid/ofw172.346

Cited by 13 publications

(16 citation statements)

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“…However, the latter is almost twice what has been reported in the Russian Federation [23,24]. ART enrollment in our study reflects the endpoint of cohort analysis approach which has not been the case with other published studies reported on ART uptake in Ukraine and other parts of the world [25,26]. Studies which do not use the cohort approach will tend to exaggerate ART uptake figures [27].…”

Section: Scontrasting

confidence: 54%

Linking intravenous drug users to treatment through non-governmental organizations in Ukraine: how well is it working?

Kuznetsova

Sereda

Denisiuk

et al. 2019

J Infect Dev Ctries

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Introduction: Alliance for Public Health, the International Charitable Foundation, coordinates HIV prevention in Non-Governmental Organizations (NGO) working with people who inject drugs (PWID) in Ukraine. We aimed to describe the performance of the differential model of linking PWID to HIV care and treatment (Community Initiated Treatment Intervention – CITI). Methodology: A retrospective cohort study using routine program data was conducted among 8,927 PWID who were tested positive for the first time during January 2016 – June 2017. Study outcomes were enrollment into CITI and initiating antiretroviral treatment (ART). Factors associated with outcomes were estimated by logistic regressions with random effects. Results: Among the study participants, 54% enrolled into CITI and 23% initiated ART. CITI enrolment was associated with being married (adjusted odds ratio (AOR) = 1.17; 95%: 1.02-1.34); less than weekly compared to daily (AOR = 1.31; 95%: 1.13-1.52); less than 5 years of drug use compared to > 14 years (AOR = 1.73; 95%: 1.40-2.13), and having no criminal records (AOR = 1.30; 95%: 1.12-1.50). Factors of non-ART initiation were male gender (AOR = 1.33; 95%: 1.16-1.53); being single (AOR = 1.48; 95%: 1.21-1.82); drug use duration > 14 years compared to < 5 years (AOR = 1.38; 95%: 1.03-1.85), unemployment (AOR = 1.45; 95%: 1.15-1.83) and history of incarceration (AOR = 1.21; 95%: 1.003-1.45). Conclusion: Mobilizing the NGO community and PWID to engage in outreach HIV testing activity and harm reduction for key populations has succeeded in opening the gateway to prevention, care and ART for thousands of PWID in Ukraine.

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Section: Scontrasting

confidence: 54%

Linking intravenous drug users to treatment through non-governmental organizations in Ukraine: how well is it working?

Kuznetsova

Sereda

Denisiuk

et al. 2019

J Infect Dev Ctries

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“…Although a few initially expressed their concern of further overburdening the already fragile health system, majority agreed that integrating HTN care will not only reduce the double burden, but it will also increase access, enable healthcare workers to treat and cater to the healthcare needs of the HIV patients in one location at a single-entry point, which will potentially reduce stigmatization and wait time at the HIV clinics. This strategy is similar to the one-stop shop integrated healthcare delivery model which has been shown, in studies conducted in South Africa[32], Kenya[33], Nigeria[34] and Malawi[35], to improve HIV patient’s access to prevention and treatment resources.…”

Section: Discussionmentioning

confidence: 99%

Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria

et al. 2019

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Background Given the growing burden of cardiovascular diseases in sub-Saharan Africa, global donors and governments are exploring strategies for integrating evidence-based cardiovascular diseases prevention into HIV clinics. We assessed the capabilities, motivations and opportunities that exist for HIV clinics to apply evidence-based strategies for hypertension control among people living with HIV (PLHIV) in Nigeria. Methods We used a concurrent Quan-Qual- study approach (a quantitative first step using structured questionnaires followed by a qualitative approach using stakeholder meetings).We invited key stakeholders and representatives of HIV and non-communicable disease organizations in Lagos, Nigeria to 1) assess the capacity of HIV clinics (n = 29) to, and; 2) explore their attitudes and perceptions towards implementing evidence-based strategies for hypertension management in Lagos, Nigeria (n = 19)The quantitative data were analyzed using SPSS whereas responses from the stakeholders meeting were coded and analyzed using thematic approach and an implementation science framework, the COM-B (Capabilities, Opportunities, Motivations and Behavior) model, guided the mapping and interpretation of the data. Results Out of the 29 HIV clinics that participated in the study, 28 clinics were public, government-owned facilities with 394 HIV patients per month with varying capabilities, opportunities and motivations for integrating evidence-based hypertension interventions within their services for PLHIV. Majority of the clinics (n = 26) rated medium-to-low on the psychological capability domains, while most of the clinics (n = 25) rated low on the physical capabilities of integrating evidence-based hypertension interventions within HIV clinics. There was high variability in the ratings for the opportunity domains, with physical opportunities rated high in only eight HIV clinics, two clinics with a medium rating and nineteen clinics with a low rating. Social opportunity domain tended to be rated low in majority of the HIV clinics (n = 21). Lastly, almost all the HIV clinics (n = 23) rated high on the reflective motivation domain although automatic motivations tended to be rated low across the HIV clinics. Conclusion In this study, we found that with the exception of motivations, the relative capabilities whether physical or psychological and the relative opportunities for integrating evidence-based hypertension intervention within HIV clinics in Nigeria were minimal. Thus, there is need to strengthen the HIV clinics in Lagos for the implementation of evidence-based hypertension interventions within HIV clinics to improve patient outcomes and service delivery in Southwest Nigeria.

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“…A similar combination intervention strategy (POC CD4+ testing, accelerated ART initiation, mobile phone appointment reminders, health educational packages and noncash financial incentives) in eSwatini improved 12-month retention in care (RR = 1.48; 95% CI = 1.18-1.86; p = 0.002) with a non-significant increase linkage to care (RR = 1.08; 95% CI = 0.97-1.21; p = 0.13) and ART initiation (RR = 1.16; 95% CI = 0.96-1.40; p = 0.12) [26]. In a nonrandomised study in Nigeria, 'One Stop Shops' (integrated services for HIV testing and counselling, STI treatment, clinical referrals and ART to key populations) had ART initiation rates of 25% compared to 4% in standard clinics (p = < 0.001) [27].…”

Section: General Adult Populationsmentioning

confidence: 98%

A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

et al. 2020

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Purpose of Review We reviewed interventions to improve uptake and adherence to antiretroviral therapy (ART) in African countries in the Treat All era. Recent Findings ART initiation can be improved by facilitated rapid receipt of first prescription, including community-based linkage and point-of-care strategies, integration of HIV care into antenatal care and peer support for adolescents. For people living with HIV (PLHIV) on ART, scheduled SMS reminders, ongoing intensive counselling for those with viral non-suppression and economic incentives for the most deprived show promise. Adherence clubs should be promoted, being no less effective than facility-based care for stable patients. Tracing those lost to follow-up should be targeted to those who can be seen face-to-face by a peer worker. Summary Investment is needed to promote linkage to initiating ART and for differentiated approaches to counselling for youth and for those with identified suboptimal adherence. More evidence from within Africa is needed on cost-effective strategies to identify and support PLHIV at an increased risk of non-adherence across the treatment cascade.

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One-Stop Shop: A Community-Based Antiretroviral Therapy (ART) Clinic Model to Improve Human Immunodeficiency Virus (HIV) Prevention and Treatment Cascade for Key Populations in Nigeria

Cited by 13 publications

References 0 publications

Linking intravenous drug users to treatment through non-governmental organizations in Ukraine: how well is it working?

Linking intravenous drug users to treatment through non-governmental organizations in Ukraine: how well is it working?

Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria

A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

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