Enhancing Public Health HIV Interventions: A Qualitative Meta-Synthesis and Systematic Review of Studies to Improve Linkage to Care, Adherence, and Retention

Joseph D. Tucker, Lai Sze Tso, Brian Hall, Qingyan Ma, Rachel Beanland, John Best, Haochu Li, Mellanye Lackey, Gifty Marley, Zachary C. Rich, Ka lon Sou, Meg Doherty

Research output: Contribution to journalArticle

Abstract

Although HIV services are expanding, few have reached the scale necessary to support universal viral suppression of individuals living with HIV. The purpose of this systematic review was to summarize the qualitative evidence evaluating public health HIV interventions to enhance linkage to care, antiretroviral drug (ARV) adherence, and retention in care. We searched 19 databases without language restrictions. The review collated data from three separate qualitative evidence reviews addressing each of the three outcomes along the care continuum. 21,738 citations were identified and 24 studies were included in the evidence review. Among low and middle-income countries in Africa, men living with HIV had decreased engagement in interventions compared to women and this lack of engagement among men also influenced the willingness of their partners to engage in services. Four structural issues (poverty, unstable housing, food insecurity, lack of transportation) mediated the feasibility and acceptability of public health HIV interventions. Individuals living with HIV identified unmet mental health needs that interfered with their ability to access HIV services. Persistent social and cultural factors contribute to disparities in HIV outcomes across the continuum of care, shaping the context of service delivery among important subpopulations.

Original languageEnglish (US)
Pages (from-to)163-171
Number of pages9
JournalEBioMedicine
Volume17
DOIs
StatePublished - Mar 1 2017

Keywords

  • HIV
  • Intervention
  • Public health
  • Qualitative
  • Systematic review

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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