A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries
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BEHAVIORAL-BIO-MEDICAL INTERFACE (RJ DICLEMENTE AND JL BROWN, SECTION EDITORS)
A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries Rebecca Jopling 1 & Primrose Nyamayaro 2 & Lena S Andersen 3 & Ashraf Kagee 4 & Jessica E Haberer 5 & Melanie Amna Abas 1 Published online: 10 August 2020 # The Author(s) 2020
Abstract 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. Keywords HIV . Interventions . Adherence . Antiretroviral therapy (ART) . Retention in care . ART initiation . Review
Jessica E Haberer and Melanie Amna Abas contributed equally to this work. This article is part of the Topical Collection on Behavioral-Bio-Medical Interface Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11904-020-00511-4) contains supplementary material, which is available to authorized users. * Melanie Amna Abas [email protected]
1
Rebecca Jopling [email protected]
Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
2
Primrose Nyamayaro [email protected]
Department of Psychiatry, University of Zimbabwe College of Health Sciences, Mazowe Street, Avondale, Harare, Zimbabwe
3
HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital Anzio Road, Observatory, Cape Town, South Africa
Ashraf Kagee [email protected]
4
Department of Psychology, Stellenbosch University, Stellenbosch 7602, South Africa
Jessica E Haberer [email protected]
5
Center for Global Health, Massachusetts General Hospital, Harvard Medical School, Boston, USA
Lena S Andersen [email protected]
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Introduction The establishment of the 90-90-90 goals was a turning point for African countries, with the potential to save millions of lives and avert future costs for patients and their famil
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