# name
Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA)
                Collaboration

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International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

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INTRODUCTION: HIV care and treatment programmes worldwide are
                transforming as they push to deliver universal access to
                essential prevention, care and treatment services to persons
                living with HIV and their communities. The characteristics and
                capacity of these HIV programmes affect patient outcomes and
                quality of care. Despite the importance of ensuring optimal
                outcomes, few studies have addressed the capacity of HIV
                programmes to deliver comprehensive care. We sought to describe
                such capacity in HIV programmes in seven regions worldwide.
                METHODS: Staff from 128 sites in 41 countries participating in
                the International epidemiologic Databases to Evaluate AIDS
                completed a site survey from 2009 to 2010, including sites in
                the Asia-Pacific region (n=20), Latin America and the Caribbean
                (n=7), North America (n=7), Central Africa (n=12), East Africa
                (n=51), Southern Africa (n=16) and West Africa (n=15). We
                computed a measure of the comprehensiveness of care based on
                seven World Health Organization-recommended essential HIV
                services. RESULTS: Most sites reported serving urban (61%;
                region range (rr): 33-100%) and both adult and paediatric
                populations (77%; rr: 29-96%). Only 45% of HIV clinics that
                reported treating children had paediatricians on staff. As for
                the seven essential services, survey respondents reported that
                CD4+ cell count testing was available to all but one site, while
                tuberculosis (TB) screening and community outreach services were
                available in 80 and 72%, respectively. The remaining four
                essential services - nutritional support (82%), combination
                antiretroviral therapy adherence support (88%), prevention of
                mother-to-child transmission (PMTCT) (94%) and other prevention
                and clinical management services (97%) - were uniformly
                available. Approximately half (46%) of sites reported offering
                all seven services. Newer sites and sites in settings with low
                rankings on the UN Human Development Index (HDI), especially
                those in the President's Emergency Plan for AIDS Relief focus
                countries, tended to offer a more comprehensive array of
                essential services. HIV care programme characteristics and
                comprehensiveness varied according to the number of years the
                site had been in operation and the HDI of the site setting, with
                more recently established clinics in low-HDI settings reporting
                a more comprehensive array of available services. Survey
                respondents frequently identified contact tracing of patients,
                patient outreach, nutritional counselling, onsite viral load
                testing, universal TB screening and the provision of isoniazid
                preventive therapy as unavailable services. CONCLUSIONS: This
                study serves as a baseline for on-going monitoring of the
                evolution of care delivery over time and lays the groundwork for
                evaluating HIV treatment outcomes in relation to site capacity
                for comprehensive care.

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Journal of the International AIDS Society, 2014, num. 17, p. 19045

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA)
                Collaboration