Effect of community-based interventions targeting female sex workers along the HIV care cascade in sub-Saharan Africa: a systematic review and meta-analysis.
Effect of community-based interventions targeting female sex workers along the HIV care cascade in sub-Saharan Africa: a systematic review and meta-analysis.
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DOI：
10.1186/s13643-021-01688-4
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发表时间：
2021-05-06
影响因子：
3.7
通讯作者：
Nyasulu PS
中科院分区：
文献类型：
--
作者：
Atuhaire L;Adetokunboh O;Shumba C;Nyasulu PS
女性性工作者极易感染人体免疫机能丧失病毒。因此，建议将基于社区的有针对性的干预措施作为护理模式之一，以改善获得艾滋病毒服务的机会和继续参与护理。我们进行了一项系统性综述，以（1）评估以FSW为目标的社区干预措施对改善艾滋病毒服务获得的影响，沿着治疗级联，（2）描述以社区为基础的干预措施，积极影响撒哈拉以南非洲FSW艾滋病毒治疗级联的艾滋病毒护理持续性。我们定义了构成艾滋病毒护理级联的5个步骤，并将其归类为结果，即艾滋病毒检测和诊断、与护理的联系、接受ART和实现病毒抑制。我们对2004年至2020年在撒哈拉以南非洲国家进行的随机对照试验、队列和横断面研究进行了系统检索。选择这一时期的依据是，通过在撒哈拉以南非洲广泛推出综合艾滋病毒方案，扩大抗逆转录病毒治疗的时间跨度。我们回顾了关于在任何艾滋病毒护理级联阶段实施社区干预措施的研究数据。在可能的情况下，使用随机效应荟萃分析对数据进行分析，对于其余研究，使用汇总统计对数据进行合成。观察到社区干预措施对艾滋病毒检测、艾滋病毒诊断和抗逆转录病毒疗法使用的重大影响。然而，在艾滋病毒检测和抗逆转录病毒疗法的使用方面，改进并没有在整个执行期间持续下去。对艾滋病毒诊断有影响的干预措施很少，只有一种社区服务提供模式具有重要意义。一般来说，产生合理影响的干预措施是在一个地点实施有针对性的全面艾滋病毒服务一揽子计划，并针对每个级联阶段制定独特战略。从这次审查中提出的证据表明，以社区为基础的干预措施的效果在艾滋病毒护理级联的不同阶段各不相同。一个广泛的一揽子干预措施，包括行为，生物医学和结构的组合，设计了具体的战略，独特的每个级联阶段似乎是更有效的，虽然长期治疗结果的信息和程度FSW仍然从事护理是稀疏的。有必要开展进一步的研究，以深化评估基于社区的干预措施对FSW艾滋病毒护理级联的有效性。这将有助于确定以证据为基础的最佳干预措施，指导将稀缺资源有效分配给对艾滋病毒服务提供产生重大影响的战略。PROSPERO CRD 42020157623
Female sex workers are extremely vulnerable and highly susceptible to being infected with human immunodeficiency virus. As a result, community-based targeted interventions have been recommended as one of the models of care to improve access to HIV services and continued engagement in care. We conducted a systematic review to (1) assess the effect of FSW-targeted community interventions on the improvement of HIV services access along the treatment cascade and (2) describe community-based interventions that positively affect continuation in HIV care across the HIV treatment cascade for FSWs in sub-Saharan Africa. We defined the 5 steps that make up the HIV care cascade and categorized them as outcomes, namely, HIV testing and diagnosis, linkage to care, receipt of ART, and achievement of viral suppression. We conducted a systematic search of randomized controlled trials, cohort, and cross-sectional studies done in sub-Saharan African countries and published from 2004 to 2020. The period was selected based on the time span within which ART was scaled up through widespread roll-out of comprehensive HIV programs in sub-Saharan Africa. We reviewed studies with data on the implementation of community interventions for any of the HIV care cascade stage. The data were analyzed using random effects meta-analysis where possible, and for the rest of the studies, data were synthesized using summary statistics. The significant impact of the community interventions was observed on HIV testing, HIV diagnosis, and ART use. However, for HIV testing and ART use, the improvement was not sustained for the entire period of implementation. There were minimal interventions that had impact on HIV diagnosis, with only one community service delivery model showing significance. Generally, the interventions that had reasonable impact are those that implemented targeted and comprehensive package of HIV services provided at one location, and with unique strategies specific to each cascade stage. The evidence brought forward from this review shows that the effect of community-based interventions varies across the different stages of HIV care cascade. A broad package of interventions including a combination of behavioral, biomedical, and structural, designed with specific strategies, unique to each cascade stage appears to be more effective, although information on long-term treatment outcomes and the extent to which FSWs remain engaged in care is sparse. There is need to conduct a further research to deepen the assessment of the effectiveness of community-based interventions on HIV care cascade for FSWs. This will enhance identification of evidence-based optimal interventions that will guide effective allocation of scarce resources for strategies that would have a significant impact on HIV service delivery. PROSPERO CRD42020157623
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影响因子：
4.4
作者：
Kelvin EA;George G;Mwai E;Kinyanjui S;Romo ML;Odhiambo JO;Oruko F;Nyaga E;Govender K;Mantell JE
通讯作者：
Mantell JE
对非洲女性性工作者的基于设施的性和生殖健康服务的系统审查。
影响因子：
10.8
作者：
Dhana A;Luchters S;Moore L;Lafort Y;Roy A;Scorgie F;Chersich M
通讯作者：
Chersich M
影响因子：
2.2
作者：
Kay ES;Batey DS;Mugavero MJ
通讯作者：
Mugavero MJ
DOI：
10.1097/qai.0000000000002123
发表时间：
2019-10-01
影响因子：
3.6
作者：
Kerrigan, Deanna;Mbwambo, Jessie;Galai, Noya
通讯作者：
Galai, Noya
影响因子：
4.5
作者：
Luchters, Stanley;Chersich, Matthew F.;Temmerman, Marleen
通讯作者：
Temmerman, Marleen