| Title |
Community-Based Interventions to Improve and Sustain Antiretroviral Therapy Adherence, Retention in HIV Care and Clinical Outcomes in Low- and Middle-Income Countries for Achieving the UNAIDS 90-90-90 Targets
|
|---|---|
| Published in |
Current HIV/AIDS Reports, July 2016
|
| DOI | 10.1007/s11904-016-0325-9 |
| Pubmed ID | |
| Authors |
Jean B. Nachega, Olatunji Adetokunboh, Olalekan A. Uthman, Amy W. Knowlton, Frederick L. Altice, Mauro Schechter, Omar Galárraga, Elvin Geng, Karl Peltzer, Larry W. Chang, Gilles Van Cutsem, Shabbar S. Jaffar, Nathan Ford, Claude A. Mellins, Robert H. Remien, Edward J. Mills |
| Abstract |
Little is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low- and middle-income countries (LMICs). We systematically searched four electronic databases for all available randomized controlled trials (RCTs) and comparative cohort studies in LMICs comparing community versus health facility-based interventions. Relative risks (RRs) for pre-defined adherence, treatment engagement (linkage and retention in care), and relevant clinical outcomes were pooled using random effect models. Eleven cohort studies and eleven RCTs (N = 97,657) were included. Meta-analysis of the included RCTs comparing community- versus health facility-based interventions found comparable outcomes in terms of ART adherence (RR = 1.02, 95 % CI 0.99 to 1.04), virologic suppression (RR = 1.00, 95 % CI 0.98 to 1.03), and all-cause mortality (RR = 0.93, 95 % CI 0.73 to 1.18). The result of pooled analysis from the RCTs (RR = 1.03, 95 % CI 1.01 to 1.06) and cohort studies (RR = 1.09, 95 % CI 1.03 to 1.15) found that participants assigned to community-based interventions had statistically significantly higher rates of treatment engagement. Two studies found community-based ART delivery model either cost-saving or cost-effective. Community- versus facility-based models of ART delivery resulted in at least comparable outcomes for clinically stable HIV-infected patients on treatment in LMICs and are likely to be cost-effective. |
X Demographics
The data shown below were collected from the profiles of 19 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 6 | 32% |
| India | 1 | 5% |
| Jamaica | 1 | 5% |
| Nigeria | 1 | 5% |
| United Kingdom | 1 | 5% |
| Colombia | 1 | 5% |
| Unknown | 8 | 42% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 14 | 74% |
| Practitioners (doctors, other healthcare professionals) | 5 | 26% |
Mendeley readers
The data shown below were compiled from readership statistics for 268 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Switzerland | 1 | <1% |
| Unknown | 267 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 62 | 23% |
| Researcher | 35 | 13% |
| Student > Ph. D. Student | 35 | 13% |
| Student > Postgraduate | 15 | 6% |
| Student > Bachelor | 15 | 6% |
| Other | 47 | 18% |
| Unknown | 59 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 84 | 31% |
| Nursing and Health Professions | 43 | 16% |
| Social Sciences | 28 | 10% |
| Psychology | 7 | 3% |
| Agricultural and Biological Sciences | 6 | 2% |
| Other | 36 | 13% |
| Unknown | 64 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 26. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 November 2022.
All research outputs
#1,265,879
of 23,016,919 outputs
Outputs from Current HIV/AIDS Reports
#19
of 434 outputs
Outputs of similar age
#26,026
of 366,409 outputs
Outputs of similar age from Current HIV/AIDS Reports
#1
of 6 outputs
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So far Altmetric has tracked 434 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one has done particularly well, scoring higher than 95% of its peers.
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