Intergenerational spillover effects of antiretroviral therapy in sub-Saharan Africa: a scoping review and future directions for research.
Intergenerational spillover effects of antiretroviral therapy in sub-Saharan Africa: a scoping review and future directions for research.
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DOI：
10.1136/bmjgh-2022-011079
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发表时间：
2023-04
影响因子：
8.1
通讯作者：
De Neve JW
中科院分区：
文献类型：
--
作者：
Schröder H;Yapa HM;Gómez-Olivé FX;Thirumurthy H;Seeley J;Bärnighausen T;De Neve JW
抗逆转录病毒疗法(ART)可能会影响那些没有接受干预但与接受干预的人有某种联系的人。然而，对于我们所说的艺术溢出效应的规模和范围，我们知之甚少。我们探索了抗逆转录病毒疗法在撒哈拉以南非洲(SSA)的代际溢出效应，并为未来的研究确定了几个方向。我们在2022年3月至4月期间进行了范围划分审查。我们系统地检索了PubMed、SqucINFO、Econlit、OTearker、AIDSInfo、Web of Science、CINHAL、Google Scholar和African Index Medicus。我们分析了纳入的研究随时间的分布情况，并总结了他们的发现。我们研究了向感染艾滋病毒的工作年龄成年人提供抗逆转录病毒药物对儿童(向下溢出效应)和老年人(向上溢出效应)的代际影响。我们根据我们对纳入研究的分析得出的广泛主题，对代际溢出效应的类型进行了分类。我们确定了2005至2022年间发表的26项研究，其中16项研究评估了成人对儿童的溢出效应(向下)，1项研究明确评估了工作年龄成年人对老年人的溢出效应(向上)。其余的研究没有完全明确溢出效应的方向。ART对家庭和家庭成员的大多数溢出效应是有益的，包括在财富、劳动力市场结果、健康结果和卫生服务利用率、教育和家庭结构方面的改善。儿童和老年人都受益于成人中获得抗逆转录病毒药物。只有三项研究报告了有害的溢出效应，其中包括与抗逆转录病毒治疗后第一年的医疗服务利用和食品不安全相关的财务和机会成本。抗逆转录病毒治疗可能会在SSA的几代人和不同部门之间产生巨大的溢出效应。需要进一步研究，以利用正面溢出效应，同时减轻潜在的负面溢出效应。在没有考虑这些社会效益的情况下，对诸如抗逆转录病毒治疗等大规模卫生干预措施的投资回报可能被低估。
Antiretroviral therapy (ART) may influence individuals who do not receive the intervention but who are connected in some way to the person who does. Relatively little is known, however, about the size and scope of, what we term, spillover effects of ART. We explored intergenerational spillover effects of ART in sub-Saharan Africa (SSA) and identified several directions for future research. We conducted a scoping review between March and April 2022. We systematically searched PubMed, PsycINFO, EconLit, OTseeker, AIDSInfo, Web of Science, CINHAL, Google Scholar and African Index Medicus. We analysed the distribution of included studies over time and summarised their findings. We examined the intergenerational impact of ART provision to working-age adults living with HIV on children (‘downward’ spillover effects) and older adults (‘upward’ spillover effects). We categorised types of intergenerational spillover effects according to broad themes which emerged from our analysis of included studies. We identified 26 studies published between 2005 and 2022 with 16 studies assessing spillover effects from adults to children (downward), and 1 study explicitly assessing spillover effects from working-age adults to older adults (upward). The remaining studies did not fully specify the direction of spillover effects. Most spillover effects of ART to household and family members were beneficial and included improvements in wealth, labour market outcomes, health outcomes and health services utilisation, schooling, and household composition. Both children and older adults benefited from ART availability among adults. Detrimental spillover effects were only reported in three studies and included financial and opportunity costs associated with health services utilisation and food insecurity in the first year after ART. ART may lead to substantial spillover effects across generations and sectors in SSA. Further research is needed to capitalise on positive spillover effects while mitigating potential negative spillover effects. The returns to investments in large-scale health interventions such as ART may be underestimated without considering these societal benefits.
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DOI：
10.1016/s1473-3099(10)70224-3
发表时间：
2011-04
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Curtis V;Schmidt W;Luby S;Florez R;Touré O;Biran A
通讯作者：
Biran A
影响因子：
3.5
作者：
Baranov, Victoria;Bennett, Daniel;Kohler, Hans-Peter
通讯作者：
Kohler, Hans-Peter
影响因子：
1.3
作者：
Coetzee, Celeste
通讯作者：
Coetzee, Celeste
影响因子：
1.5
作者：
Chigwedere, Pride;Seage, George R., III;Essex, M.
通讯作者：
Essex, M.
DOI：
10.1111/j.1467-8268.2009.00207.x
发表时间：
2009-04-01
影响因子：
2.9
作者：
d'Adda, Giovanna;Goldstein, Markus;Thirumurthy, Harsha
通讯作者：
Thirumurthy, Harsha