Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings

Bibliographic Data

ID19440342
AuthorsAnne Spaar (University of Bern), Claire Graber (Institute of Social and Preventive Medicine), François Dabis (0000-0002-1614-8857), Anna Coutsoudis (0000-0002-9078-5037, University of KwaZulu-Natal), L Bachmann (University Hospital of Zurich), L M Bachmann (0000-0003-3760-3465, University Hospital of Zurich), James Mcintyre (0000-0002-9150-1059, Perinatal HIV Research Unit), Mauro Schechter (0000-0003-2362-9170, Universidade Federal do Estado do Rio de Janeiro), Hans Prozesky (0000-0001-9715-3449, Tygerberg Hospital), H W Prozesky (g Tygerberg Academic Hospital , Cape Town , South Africa), Suely Tuboi (0000-0003-3612-231X, Universidade Federal do Estado do Rio de Janeiro), David Dickinson (0009-0007-5981-9562, Botswana Vaccine Institute (Botswana)), N Kumarasamy (i Y R Gaitonde Centre for AIDS Research and Education (YRG Care) , Chennai , India), M Pujades-Rodriquez (University of Bern), Eduardo Sprinz (0000-0003-4343-8304, Hospital de Clínicas de Porto Alegre), Herbert Schilthuis (Heineken (Netherlands)), H J Schilthuis (l Heineken Medical Services , Amsterdam , The Netherlands), Pedro Cahn (0000-0002-9381-1931, Fundación Huésped), Nicholas Low (0000-0003-4817-8986, Institute of Social and Preventive Medicine), Matthias Egger (0000-0002-1791-1842, University of Bern, corresponding author), for ART-LINC of IeDEA for ART-LINC of IeDEA, for ART-LINC of IeDEA
Year2010
Volume22
Issue6
Pages775-783
Publication date2010-06-01
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540120903349102
PMID20473792
PMCIDPMC2888993
OpenAlexW2110203280
LanguageEN
Citations received6
References cited25

Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely

Antiretroviral therapy · Business · Developing country · Economic growth · Environmental health · Family medicine · Focus group · Serodiscordant · Socioeconomics · Sociology · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine

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