Integrating cervical cancer with HIV healthcare services: A systematic review
| Autor: | Nicola Watt, Louise Sigfrid, Victoria Haldane, Sue Hogarth, Pablo Perel, Francisco Cervero-Liceras, Alconada Alvaro, Peter Piot, Laura Otero-García, Fiona Leh Hoon Chuah, Georgina A. V. Murphy, Martin McKee, Dina Balabanova, Will Maimaris, Helena Legido-Quigley, Kent Buse, Suan Ee Ong |
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| Přispěvatelé: | UAM. Departamento de Cirugía |
| Předmět: |
RNA viruses
Health Screening Service delivery framework Services Cancer Treatment Psychological intervention lcsh:Medicine Uterine Cervical Neoplasms HIV Infections Review Pathology and Laboratory Medicine Cervical Cancer 0302 clinical medicine Immunodeficiency Viruses Cancer screening Health care Medicine and Health Sciences Global health Public and Occupational Health 030212 general & internal medicine lcsh:Science Cervical cancer education.field_of_study 030219 obstetrics & reproductive medicine Multidisciplinary HIV diagnosis and management Oncology Medical Microbiology Viral Pathogens Viruses Female Pathogens Cancer Screening Research Article medicine.medical_specialty Medicina HIV prevention Population Microbiology 03 medical and health sciences Signs and Symptoms Diagnostic Medicine Retroviruses Cancer Detection and Diagnosis medicine Humans education Microbial Pathogens Preventive medicine Gynecology business.industry Public health lcsh:R Lentivirus Organisms Biology and Life Sciences HIV Cancers and Neoplasms medicine.disease Family medicine Lesions lcsh:Q business Gynecological Tumors |
| Zdroj: | BASE-Bielefeld Academic Search Engine Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid Repositorio Abierto de la UdL Universitad de Lleida Recercat. Dipósit de la Recerca de Catalunya instname PLoS ONE Biblos-e Archivo. Repositorio Institucional de la UAM PLoS ONE, Vol 12, Iss 7, p e0181156 (2017) |
| ISSN: | 1932-6203 |
| Popis: | This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Cervical cancer is a major public health problem. Even though readily preventable, it is the fourth leading cause of death in women globally. Women living with HIV are at increased risk of invasive cervical cancer, highlighting the need for access to screening and treatment for this population. Integration of services has been proposed as an effective way of improving access to cervical cancer screening especially in areas of high HIV prevalence as well as lower resourced settings. This paper presents the results of a systematic review of programs integrating cervical cancer and HIV services globally, including feasibility, acceptability, clinical outcomes and facilitators for service delivery. Methods This is part of a larger systematic review on integration of services for HIV and non-communicable diseases. To be considered for inclusion studies had to report on programs to integrate cervical cancer and HIV services at the level of service delivery. We searched multiple databases including Global Health, Medline and Embase from inception until December 2015. Articles were screened independently by two reviewers for inclusion and data were extracted and assessed for risk of bias. Main results 11,057 records were identified initially. 7,616 articles were screened by title and abstract for inclusion. A total of 21 papers reporting interventions integrating cervical cancer care and HIV services met the criteria for inclusion. All but one study described integration of cervical cancer screening services into existing HIV services. Most programs also offered treatment of minor lesions, a ‘screen-and-treat’ approach, with some also offering treatment of larger lesions within the same visit. Three distinct models of integration were identified. One model described integration within the same clinic through training of existing staff. Another model described integration through co-location of services, with the third model describing programs of integration through complex coordination across the care pathway. The studies suggested that integration of cervical cancer services with HIV services using all models was feasible and acceptable to patients. However, several barriers were reported, including high loss to follow up for further treatment, limited human-resources, and logistical and chain management support. Using visual screening methods can facilitate screening and treatment of minor to larger lesions in a single ‘screen-and-treat’ visit. Complex integration in a single-visit was shown to reduce loss to follow up. The use of existing health infrastructure and funding together with comprehensive staff training and supervision, community engagement and digital technology were some of the many other facilitators for integration reported across models. Conclusions This review shows that integration of cervical cancer screening and treatment with HIV services using different models of service delivery is feasible as well as acceptable to women living with HIV. However, the descriptive nature of most papers and lack of data on the effect on long-term outcomes for HIV or cervical cancer limits the inference on the effectiveness of the integrated programs. There is a need for strengthening of health systems across the care continuum and for high quality studies evaluating the effect of integration on HIV as well as on cervical cancer outcomes Funding was received from The Joint United Nations Programme on HIV/AIDS (UNAIDS) grant number ADDEVH48, which covered for HL-Q's salary and payment for accessing papers |
| Databáze: | OpenAIRE |
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