Approaches to transitioning women into and out of prevention of mother-to-child transmission of HIV services for continued ART: a systematic review.
Approaches to transitioning women into and out of prevention of mother-to-child transmission of HIV services for continued ART: a systematic review.
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DOI：
10.1002/jia2.25633
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发表时间：
2021-01
影响因子：
6
通讯作者：
Abrams EJ
中科院分区：
文献类型：
--
作者：
Phillips TK;Teasdale CA;Geller A;Ng'eno B;Mogoba P;Modi S;Abrams EJ
携带艾滋病毒的妇女必须在怀孕时过渡到预防母婴传播艾滋病毒（PMTCT）服务，并在分娩后返回抗逆转录病毒治疗服务。过渡时期可能是一个脆弱的时期，许多妇女失去了艾滋病毒护理，但几乎没有关于最佳过渡方法的指导，以确保护理的连续性。我们审查了现有的证据，包括使妇女转入和退出预防母婴传播的现有方法、转入后的结果以及影响成功转入的因素。我们检索了PubMed和SCOPUS，以及2006年1月至2020年7月期间国际HIV会议的摘要。纳入的研究检查了三个过渡点：已经接受抗逆转录病毒治疗的孕妇转入预防母婴传播（过渡1），感染艾滋病毒的孕妇尚未接受抗逆转录病毒治疗（过渡2），产后妇女在分娩后从预防母婴传播转入一般抗逆转录病毒治疗（过渡3）。将结果分组并报告为对转换方法的描述、转换后结果的比较以及影响成功转换的因素。在检索到的1809篇摘要中，本综述纳入了36项研究（39篇论文）。3项研究包括过渡1、26项过渡2和17项过渡3。26项研究描述了过渡方法，可分为在过渡点提供信息（n = 8），加强服务之间的通信或数据链接（n = 4），使用过渡导航器（n = 12）和组合方法（n = 4）。很少有研究直接评估过渡，只有9项研究比较了过渡方法之间的结果，研究设计、环境和结果存在很大的异质性。在报告影响成功过渡因素的25项研究中确定了四个主题：恐惧、知识和准备、临床特征以及过渡要求和过程。本综述强调，尽管在许多情况下，妇女需要过渡到预防母婴传播服务以继续抗逆转录病毒治疗，但关于最佳过渡方法的证据非常有限。需要进行持续的业务研究，以确定可持续和可接受的过渡方法和服务提供模式，以支持怀孕期间和怀孕后艾滋病毒护理的连续性。
Women living with HIV are required to transition into the prevention of mother‐to‐child transmission of HIV (PMTCT) services when they become pregnant and back to ART services after delivery. Transition can be a vulnerable time when many women are lost from HIV care yet there is little guidance on the optimal transition approaches to ensure continuity of care. We reviewed the available evidence on existing approaches to transitioning women into and out of PMTCT, outcomes following transition and factors influencing successful transition. We searched PubMed and SCOPUS, as well as abstracts from international HIV‐focused meetings, from January 2006 to July 2020. Studies were included that examined three points of transition: pregnant women already on ART into PMTCT (transition 1), pregnant women living with HIV not yet on ART into treatment services (transition 2) and postpartum women from PMTCT into general ART services after delivery (transition 3). Results were grouped and reported as descriptions of transition approach, comparison of outcomes following transition and factors influencing successful transition. Out of 1809 abstracts located, 36 studies (39 papers) were included in this review. Three studies included transition 1, 26 transition 2 and 17 transition 3. Approaches to transition were described in 26 studies and could be grouped into the provision of information at the point of transition (n = 8), strengthened communication or linkage of data between services (n = 4), use of transition navigators (n = 12), and combination approaches (n = 4). Few studies were designed to directly assess transition and only nine compared outcomes between transition approaches, with substantial heterogeneity in study design, setting and outcomes. Four themes were identified in 25 studies reporting on factors influencing successful transition: fear, knowledge and preparedness, clinic characteristics and the transition requirements and process. This review highlights that, despite the need for women to transition into and out of PMTCT services for continued ART in many settings, there is very limited evidence on optimal transition approaches. Ongoing operational research is required to identify sustainable and acceptable transition approaches and service delivery models that support continuity of HIV care during and after pregnancy.
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影响因子：
1.7
作者：
Clouse K;Mongwenyana C;Musina M;Bokaba D;Long L;Maskew M;Ahonkhai A;Fox MP
通讯作者：
Fox MP
影响因子：
3.2
作者：
Cawley C;McRobie E;Oti S;Njamwea B;Nyaguara A;Odhiambo F;Otieno F;Njage M;Shoham T;Church K;Mee P;Todd J;Zaba B;Reniers G;Wringe A
通讯作者：
Wringe A
影响因子：
16.1
作者：
Aliyu, Muktar H.;Blevins, Meridith;Vermund, Sten H.
通讯作者：
Vermund, Sten H.
DOI：
10.1080/09540121.2017.1282107
发表时间：
2017-01-01
影响因子：
1.7
作者：
FitzHarris, Lauren F.;Hollis, Natasha D.;Dunbar, Erica K.
通讯作者：
Dunbar, Erica K.
影响因子：
11.1
作者：
Jones, Harriet;Wringe, Alison;Renju, Jenny
通讯作者：
Renju, Jenny