Emerging priorities for HIV service delivery

Nathan Ford, Elvin Geng, Tom Ellman, Catherine Orrell, Peter Ehrenkranz, Izukanji Sikazwe, Andreas Jahn, Miriam Rabkin, Stephen Ayisi Addo, Anna Grimsrud, Sydney Rosen, Isaac Zulu, William Reidy, Thabo Lejone, Tsitsi Apollo, Charles Holmes, Ana Francisca Kolling, Rosina Phate Lesihla, Huu Hai Nguyen, Baker BakashabaLastone Chitembo, Ghion Tiriste, Meg Doherty, Helen Bygrave

Research output: Contribution to journalArticlepeer-review

Abstract

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), in 2018, an estimated 37.9 million people were living with HIV worldwide. There were also 1.7 million new infections and 770,000 deaths. At the end of June 2019, 24.5 million people were receiving antiretroviral therapy (ART). Nonetheless, increased access to high-quality ART services is needed to further reduce mortality and new infections and to optimize long term outcomes. In this article, we summarize priorities for HIV service delivery research and guidance identified through a World Health Organization (WHO) consultation held at the end of 2018. The priorities identified include linkage from HIV testing to care; rapid initiation of ART (including out-of-facility ART initiation); task sharing and decentralization, including children and patients on second line; ART delivery for stable clients; adherence, retention, and reengagement in care; management of advanced HIV disease; provision of welcoming health services; and strengthening of service integration, particulary for NCDs and family planning. Ongoing evaluation is needed to determine the net effects of introducing differentiated service delivery models, in terms of health service inputs and long-term outcomes for people living with HIV.

Original languageEnglish (US)
Article numbere1003028
JournalPLoS medicine
Volume17
Issue number2
DOIs
StatePublished - Feb 2020

ASJC Scopus subject areas

  • Medicine(all)

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