Programmatic and ethical challenges in the implementation of treatment-as-prevention in the context of HIV and drug-resistant tuberculosis co-infection in sub-Saharan Africa

Datos Bibliográficos

ID15540654
AutoresDessalegn Y Melesse (0000-0003-3917-5329, University of Manitoba, autor de correspondencia), Marissa Becker (0000-0002-9235-0547, University of Manitoba), Leigh M McClarty (0000-0003-0183-2768, University of Manitoba), Kellee Hodge (University of Manitoba), Laura H Thompson (0000-0003-3792-9772, University of Manitoba), Jenny Blanchard (0000-0002-4701-590X, University of Manitoba), Joseph M Kaufert (University of Manitoba)
Año2014
Volumen11
Número3
Páginas336-347
Fecha de publicación2014-12-16
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaGlobal Public Health (JOURNAL)
Identificadores de la revistaISSN: 1744-1692 • E-ISSN: 1744-1706
EditorialTaylor & Francis (PUBLISHER • GB)
DOI10.1080/17441692.2014.988164
PMID25513964
OpenAlexW2050276122
IdiomaEN
Referencias citadas54

There is limited literature on programmatic challenges in the implementation of a treatment-as-prevention (TasP) strategy among human immunodeficiency virus (HIV) and drug-resistant tuberculosis (DR-TB) co-infected individuals in sub-Saharan Africa (SSA). This paper highlights specific programmatic challenges surrounding the implementation of this strategy among HIV and DR-TB co-infected populations in SSA. In SSA, limitations in administrative, human and financial resources and poor health infrastructure, as well as increased duration and complexity of providing long-term treatment for HIV individuals co-infected with DR-TB, pose substantial challenges to the implementation of a TasP strategy and warrant further investigation. A comprehensive approach must be devised to implement TasP strategy, with special attention paid to the sizable HIV and DR-TB co-infected populations. We suggest that evidence-informed and human rights-based guidelines for participant protection and strategies for programme delivery must be developed and tailored to maximise the benefits to those most at risk of developing HIV and DR-TB co-infection. Assessing regional circumstances is crucial, and TasP programmes in the region should be complemented by combined prevention strategies to achieve the intended goals

Antiretroviral therapy · Business · Context (archaeology · Developing country · Drug resistant tuberculosis · Economic growth · Environmental health · Geography · Human immunodeficiency virus (HIV · Mycobacterium tuberculosis · Pathology · Treatment as prevention · Tuberculosis · Viral load · Warrant · HIV, Drug Use, Sexual Risk · HIV/AIDS Impact and Responses · HIV/AIDS Research and Interventions · Medicine · Immunology