Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings

Autor: Diana Dickinson, Nicola Low, H J Schilthuis, Hans Prozesky, Lucas M. Bachmann, Pedro Cahn, James McIntyre, François Dabis, Matthias Egger, Eduardo Sprinz, M Pujdades-Rodriquez, Anne Spaar, Marcos C. Schechter, Anna Coutsoudis, Suely H. Tuboi, Nagalingeswaran Kumarasamy, Claire Graber
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Adult
Counseling
Male
Sexually transmitted disease
medicine.medical_specialty
Asia
Health (social science)
Adolescent
Social Psychology
Social stigma
Voluntary counseling and testing
Population
HIV prevention
HIV Infections
Article
Condoms
Patient Education as Topic
Acquired immunodeficiency syndrome (AIDS)
Surveys and Questionnaires
Preventive Health Services
medicine
Humans
Child
education
Health Education
education.field_of_study
Traditional medicine
business.industry
Public health
Infant
Newborn
Public Health
Environmental and Occupational Health
Infant
Social Support
South America
Partner notification
medicine.disease
Infectious Disease Transmission
Vertical
Antiretroviral therapy
Anti-Retroviral Agents
Family medicine
Africa
Serodiscordant
resource limited setting
Female
business
Delivery of Health Care
Program Evaluation
Popis: Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely.
Databáze: OpenAIRE
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