Population health and individualized care in the global AIDS response: synergy or conflict?

  title={Population health and individualized care in the global AIDS response: synergy or conflict?},
  author={Wafaa M El-Sadr and Miriam Rabkin and KevinM. Decock},
  volume={30 14},
Extraordinary progress has been achieved in confronting the global HIV epidemic. The number of people living with HIV (PLWH) accessing antiretroviral treatment (ART) in low-income and middle-income countries rose from 400 000 in 2003 to 17 million in 2015 [1], and an estimated 7.8 million deaths have been averted by the scaleup of ART services [2]. Increased access to prevention and treatment has also led to a 35% drop in new HIV infections since 2000, including a 58% decrease amongst children… 
Patient-level and program-level monitoring and evaluation of differentiated service delivery for HIV: a pragmatic and parsimonious approach is needed
Both community-based and facility-based DARTS can reduce the burdens associated with frequent and lengthy clinic visits for both patients and health providers and aim to enhance retention, ART adherence, viral suppression, and quality of life.
Bringing HIV services to key populations and their communities in Tanzania: from pilot to scale
The FIKIA Project is described, which implemented innovative approaches to scaling up DSD models to reach and engage KP in Tanzania, which has less favourable HIV outcomes compared to the general population.
Differentiated models of service delivery for antiretroviral treatment of HIV in sub-Saharan Africa: a rapid review protocol
A rapid review of recent literature on DSD currently in use in sub-Saharan Africa and identify gaps in the literature with respect to the description of delivery models, coverage, effectiveness, and cost is conducted.
Optimizing differentiated treatment models for people living with HIV in urban Zimbabwe: Findings from a mixed methods study
DART-eligible PLHIV in Harare found it relatively easy to access HFs, and preferred attributes associated with facility-based individual models, which may be the most efficient way to sustain positive patient outcomes and increase health system performance.
Expansion and scale-up of HIV care and treatment services in four countries over ten years
Over 10 years of HIV scale-up in four sub-Saharan African countries, close to a million PLHIV were enrolled in care increasingly at rural and primary facilities with increasing CD4 count, and loss to follow-up from HIV care remains alarmingly high, particularly among pregnant women and youngerPLHIV.
Comparative assessment of five trials of universal HIV testing and treatment in sub‐Saharan Africa
Five community‐based trials have been implemented in sub‐Saharan Africa to measure the effects of various UTT strategies at population level and the contexts, research methodologies, intervention packages, themes explored, evolution of study designs and interventions related to each of these five UTT trials are described.
Cabenuva®: Differentiated service delivery and the community Pharmacists’ roles in achieving UNAIDS 2030 target in Nigeria
Integrated community-based HIV and non-communicable disease care within microfinance groups in Kenya: study protocol for the Harambee cluster randomised trial
A cluster randomised trial is used to evaluate integrated community-based care incorporated into MF groups in medium and high HIV prevalence areas in western Kenya and analyse incremental cost-effectiveness of the intervention in terms of cost per HIV suppressed person-time, cost per patient retained in care and cost per disability-adjusted life-year saved.
Persons living with HIV with advanced HIV disease: need for novel care models
Despite increasing focus on test and treat strategies for people living with HIV (PLHIV), many continue to enrol late in care and initiate antiretroviral therapy (ART) when they have advanced HIV
Tailored HIV programmes and universal health coverage
It is argued that the response both to HIV and to broader health threats should use these areas of convergence to increase health systems efficiency and mitigate the harm of any potential decrease in health funding.


Putting quality at the heart of HIV programs
The past 15 years have seen dramatic advances in confronting the HIV epidemic, with more than 12 million people starting antiretroviral therapy (ART) worldwide over the past decade – an unprecedented achievement and a 38% drop in new HIV infections since 2001.
Scale-up of HIV Treatment Through PEPFAR: A Historic Public Health Achievement
Since its inception in 2003, PEPFAR has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy.
The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settings
Simplification of Antiretroviral Therapy: A Necessary Step in the Public Health Response to HIV/AIDS in Resource-Limited Settings
Future drug and regimen choices for resource-limited settings will likely be guided by the same principles that have led to the recommendation of a single preferred regimen and will favour drugs that have the following characteristics: minimal risk of failure, efficacy and tolerability, robustness and forgiveness, no overlapping resistance in treatment sequencing, convenience, affordability, and compatibility with anti-TB and anti-hepatitis treatments.
Developing Laboratory Systems and Infrastructure for HIV Scale-Up: A Tool for Health Systems Strengthening in Resource-Limited Settings
The rapid scale-up of HIV care and treatment in resource-limited settings has overwhelmed many public health laboratory services already burdened with human resource shortages, an aging and
Task shifting from doctors to non-doctors for initiation and maintenance of antiretroviral therapy.
Assessment of the quality of initiation and maintenance of HIV/AIDS care in models that task shift care from doctors to non-doctors in Africa finds moderate quality evidence that there is probably no difference in mortality when doctors initiated therapy and nurses provided follow-up, and low quality data that death at one year may be lower in the task shifting group.
Retention of Adult Patients on Antiretroviral Therapy in Low- and Middle-Income Countries: Systematic Review and Meta-analysis 2008–2013
  • M. Fox, S. Rosen
  • Medicine
    Journal of acquired immune deficiency syndromes
  • 2015
Background:We previously published systematic reviews of retention in care after antiretroviral therapy initiation among general adult populations in sub-Saharan Africa. We estimated 36-month
Barriers to care among people living with HIV in South Africa: Contrasts between patient and healthcare provider perspectives
We collected qualitative data (semi-structured interviews with 11 healthcare providers and 10 patients; 8 focus groups with 41 patients) to identify barriers to linkage to care among people living
Game Changers: Why Did the Scale-Up of HIV Treatment Work Despite Weak Health Systems?
Further work is needed to enhance the quality of programs, to energetically tackle HIV prevention, to build on this success, and to address other health threats that these same communities face.
Family Foundation. Financing the response to HIV in low-and middle-income countries: international assistance from donor governments in 2014