Next Article in Journal
Leptospira Seroprevalence in Free-Ranging Long-Tailed Macaques (Macaca fascicularis) at Kosumpee Forest Park, Maha Sarakham, Thailand
Previous Article in Journal
Rabies Outbreak in the Urban Area of Delhi: An Investigation Report and One Health Perspective for Outbreak Management
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Infectious Disease Reports
Volume 15
Issue 1
10.3390/idr15010001
idr-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Review

Universal Health Coverage for Antiretroviral Treatment: A Review

by
Aklilu Endalamaw
1,2,*,
Charles F Gilks
1,
Fentie Ambaw
3,
Tesfa Dejenie Habtewold
4,5 and
Yibeltal Assefa
1
1
School of Public Health, The University of Queensland, Brisbane, QLD 4072, Australia
2
College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar P.O. Box 79, Ethiopia
3
School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar P.O. Box 79, Ethiopia
4
Branch of Epidemiology, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
5
Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
*
Author to whom correspondence should be addressed.
Infect. Dis. Rep. 2023, 15(1), 1-15; https://doi.org/10.3390/idr15010001
Submission received: 26 October 2022 / Revised: 16 December 2022 / Accepted: 19 December 2022 / Published: 21 December 2022
(This article belongs to the Section Viral Infections)
Browse Figures
Review Reports Versions Notes

Abstract

:
Universal health coverage is essential for the progress to end threats of the acquired immunodeficiency syndrome epidemic. The current review assesses the publication rate, strategies and barriers for antiretroviral therapy (ART) coverage, equity, quality of care, and financial protection. We searched Web of Science, PubMed, and Google Scholar. Of the available articles, 43.13% were on ART coverage, 40.28% were on financial protection, 10.43% were on quality of care, and 6.16% were on equity. A lack of ART, fear of unwanted disclosure, lack of transportation, unaffordable health care costs, long waiting time to receive care, and poverty were barriers to ART coverage. Catastrophic health care costs were higher among individuals who were living in rural settings, walked greater distances to reach health care institutions, had a lower socioeconomic status, and were immunocompromised. There were challenges to the provision of quality of care, including health care providers’ inadequate salary, high workload and inadequate health workforce, inappropriate infrastructure, lack of training opportunities, unclear division of responsibility, and the presence of strict auditing. In conclusion, ART coverage was below the global average, and key populations were disproportionally less covered with ART in most countries. Huge catastrophic health expenditures were observed. UHC contexts of ART will be improved by reaching people with poor socioeconomic status, delivering appropriate services, establishing a proper health workforce and service stewardship.

1. Introduction

Antiretroviral therapy (ART) is effective [1] in controlling viral replication and preventing acquired immunodeficiency syndrome (AIDS), which is a global threat of epidemic diseases. AIDS killed an estimated 650,000 people globally in 2021 [2]. It is the second leading cause of disability-adjusted life years among people aged 25 to 49 years [3].
Ending the global threat of AIDS epidemic is a global development goal. The United Nations (UN) member states set seventeen goals in which universal health coverage (UHC) and ending AIDS epidemic targets are integrated [4]. UHC is an action framework that builds on effective service coverage and financial protection [5]. Effective service coverage refers to (1) reproductive, maternal, and child health, (2) infectious diseases, (3) non-communicable diseases, and (4) service provision and access [6]. Financial protection comprises catastrophic health expenditure (CHE), impoverishment, and poverty due to health care costs [7]. Quality of care and equity of services are integrated in the UHC definition [8].
Equitable service, provision of quality care [9], and affordable health care [2] could reflect the accelerated progress of UHC. People living with HIV (PLHIV) should start ART based on a standardized treatment protocol [10]. It is about “providing evidence-based health care services to those who need them, avoiding harm to people for whom the care is intended, and providing care that responds to individual preferences, needs and values” [11]. Especially, providing high-quality HIV/AIDS services in low- and middle-income countries is critical [12]. Quality service delivery should not vary by age, gender, race/ethnicity, geographical location, religion, socioeconomic status, or linguistic and political affiliation [13]. There have been strategies to minimize service disparity, including mobilizing resources, establishing an ethics advisory body, creating opportunities for public dialogue, developing and implementing policies, and identifying vulnerable and marginalized populations [14].
UNAIDS has recommended conducting research on different HIV/AIDS issues [15]. Identifying gaps in the current research knowledge guides future research area [16]. Available scoping reviews [17,18] did not assess the publication rate on ART coverage, equity, quality of care, and financial protection. The current review is important to synthesize these concepts based on the available literature. Available fragmented evidence around the world is inconclusive and disaggregated. Therefore, the current review reasonably assessed ART coverage, financial protection, equity, and the quality of care; together, these dimensions are intimately linked and integrated in the UHC concept. The current review will provide evidence for policy makers and be used as a framework for researchers to conduct further research because this review is the first of its kind to incorporate four major domains into a single health topic.

2. Materials and Methods

2.1. Theoretical Framework

This review was conducted based on the UHC concept: “Universal health coverage means that all people have access to the health services they need, when and where they need them, without financial hardship” [19]. From this notion, dimensions of UHC are described as:
  • Coverage: who is covered? This concerned crude coverage in the current review;
  • Financial protection: the proportion of the costs covered, and service costs covered by insurance or other methods. The effectiveness of financial protection is measured by catastrophic health expenditure and impoverishment;
  • Equity in ART coverage: all people in need of service should be covered; the non-covered population is evidence of service disparity;
  • Quality in ART care: in UHC, effective service coverage denotes the quality of services delivered to the people covered by services. Quality of care was assessed by any of methods in this review. Quality of care and equity are integrated definitions of UHC.

2.2. Identifying a Research Question

The study was conducted using a population, concept, and context framework in a scoping review methodology [20,21,22]. In the current review, HIV/AIDS patients (population), coverage, equity, financial protection and quality of care (concept) and studies were not limited to a specific country (context).
The topic is registered in Open Science Framework (OSF|Universal Health Coverage for Antiretroviral Treatment: a scoping review). The steps started with the identification of a review question followed by setting inclusion criteria, selecting articles, extracting data, synthesizing, and reporting. The review was reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) extension for scoping reviews checklist [23].

2.3. Searching, Selection, Charting and Presenting

Web of Science, PubMed, and Google Scholar were searched between 20 October 2021 and 12 November 2021, and updated on 3 March 2022. A UNAIDS 2021 report on ART coverage was used to see the difference between researchers’ findings and the panel data report [24]. Search terms were “universal”, “health”, “health care”, “healthcare”, “health service”, “quality”, “access”, “coverage”, “equity”, “disparity”, “inequity”, “equality”, “inequality”, “expenditure”, “cost”, “HIV”, “human immunodeficiency virus”, AIDS, “acquired immunodeficiency syndrome”, “HIV/AIDS”, and “human immunodeficiency virus/acquired immunodeficiency syndrome”. “AND” or “OR” Boolean operators were used to broaden and narrow search results. Search strategy of each database is shown in supplementary file (Table S1). Articles were imported in EndNote desktop version x7 for duplication removal and citation. An automatic duplication check was performed using EndNote desktop version x7 proceeding with manual duplication removal.
Studies published in English language were included. To access research post-2015 sustainable development target 3.8, the search was restricted to include studies conducted after 2015. Non-English language, abstract only, comments to editor, erratum, perspectives, letters, and brief communications were excluded. While counting articles based on key terms, barriers, and enablers in a publication rate for each dimension, further screening was conducted to describe ART coverage (inequity) and/or strategies and barriers, catastrophic health expenditure and/or determinants (challenges) and quality of care and/or strategies and barriers. Costs or cost-effectiveness of ART, out-of-pocket expenditure, health expenditure, insurance coverage, and catastrophic health expenditure were considered in the publication description of financial protection. Quality of care was extracted when the article’s objective was on the quality of ART care or quality of care among HIV/AIDS clients in general (some did not specify ART). Inequity was disparity between countries, ethnic groups, citizen, and non-citizen and/or socioeconomic or demographic differences in ART use.
Titles, abstracts, and full texts of articles were reviewed in a stepwise approach. A piloted and refined data extraction tool was used to extract data. Data were scrutinized, charted, and tabulated based on key themes and findings. The information extracted was on author(s), publication year, World Health Organisation (WHO) regions, World Bank (WB) group, study methods, and main findings.
Available articles were compiled and summarized with frequency and percentage based on the information extracted. The types of study design were quantitative, qualitative, and mixed research. Simple descriptive analysis was carried out, and the results are presented in figures, tables, and text.

3. Results

3.1. Search Results

The selection of the studies is depicted in Figure 1. The publishing rates for ART coverage, equity, financial protection, and quality of care were examined across 211 articles. To describe ART coverage or equity, catastrophic health expenditure and quality of care, as well as strategies and challenges or determinants for each, 104 of these were included. In the Supplementary Materials (Table S2), all 211 articles’ attributes are displayed. The majority (91 articles) focused on ART coverage, followed by 85 articles on reducing financial risk protection; 22 articles were on quality of care, and 13 articles were on equity. Figure 2 shows the publishing rate for each topic.

3.2. Main Findings

The following text and figures summarize the main findings on ART coverage, equity, quality of care, and catastrophic health expenditure; the UNAIDS reports for ART coverage corresponding to available articles for all ages or key populations are described.

3.3. ART Coverage among PLHIV

The number of PLHIV who were on ART is reported; in Oman, 1682 PLHIV were on ART, whereas in China, 978,138 were; however, there were no percentage data for Oman or Japan in the 2021 UNAIDS report. The findings of the research and the UNAIDS report varied for most countries. For instance, Afghanistan (88.6% in research versus 9% in UNAIDS report) and Kazakhstan (67.8% versus 57%) exhibited disparity between subnational and national estimates. ART coverage differed between two studies conducted in the same country (65% versus 93% in Botswana and 70.7% versus 93.1% in South Africa), showing discrepancy between different settings and/or time periods (Figure 3).

3.4. ART Coverage among Key Population

Of eight countries which had research findings on key populations, UNAIDS did not report on Brazil, the USA, or Malawi. In Ukraine, ART coverage among injection drug users was higher based on research finding (70%) than the UNAIDS report (37.9%); ART coverage was lower in this group than the general population (37.9% versus 57%). In Canada, 74% of injection drug users were on ART in 2012 (based on research) and 90.3% in 2021 (based on UNAIDS report), which highlights changing coverage over time (Figure 4).

3.5. Catastrophic Health Expenditure

Catastrophic health spending was significantly higher for inpatient care than outpatient services. It was 66.7% for inpatients and 20.3% for outpatients in Cameroon, and it was 100% (inpatient) versus 40% (outpatient) in Nigeria (Figure 5).

3.6. Strategies for ART Coverage and Quality of Care

Community-based HIV prevention and treatment interventions (including home-based care and family strategy) were effective in expanding ART coverage and improving the quality of care. Strengthening financial and leadership activities increased ART coverage. Strengthening health workforce (e.g., training and increasing numbers) improved the quality of care (Table 1).

3.7. Barriers for ART Coverage, Catastrophic Health Expenditure, and Quality of Care

The lack of ART was a barrier to ART coverage in some countries. Other obstacles to extending ART and raising the standard of service were the workload faced by health care providers, stigma, and discrimination. Transportation problems were a barrier for ART coverage and catastrophic health expenditure (Table 2).

3.8. Client (Sociodemographic- and Clinical-Related) Factors

Women, urban residents, and non-immigrants had higher ART coverage rates compared with their counterparts. Those who were living in rural residences, had a lower socioeconomic status, were far from health service areas, and were immunosuppressed (lower CD4 cell counts) were at risk of catastrophic healthcare costs. Those living in rural areas and who had attended ART for more than ten years responded that the service they were receiving was of poor quality (Table 3).

4. Discussion

In this analysis, it was discovered that the high HIV risk group (MSM and FSW) had a lower ART coverage. There was a discrepancy between the national and subnational estimates of ART coverage. Catastrophic health spending was higher. A community-based HIV prevention and treatment program was successful in increasing access to ART and raising the standard of care. Leadership initiatives and financial stabilization boosted ART coverage. Strengthening the health staff increased the standard of care. Financial strengthening and leadership activities increased ART coverage. Health workforce strengthening improved the quality of care. The lack of ART was a barrier to ART coverage in some nations. Another obstacle in expanding ART and raising the standard of service was the workload placed on medical professionals. Difficulties with transportation were a barrier to ART coverage and catastrophic medical costs. Compared with their counterparts, women, urban residents, and non-immigrants had higher ART coverage rates. Those with lower socioeconomic positions, a rural residence, a greater distance from a health care region, and with a reduced immune system were subject to catastrophic health costs. Rural residents who had been receiving ART for more than ten years stated that the care they were receiving was of poor quality. The equity dimension was the least investigated topic.
The current review found that 90% or more of PLHIV who were aware of their HIV status had started ART in South Africa [66], Eswatini [67], Botswana [68], and Australia [69], all of which reported achieving their ART coverage goals. This does not imply that all of these nations are successful in providing ART to individuals in need. In South African research, for instance, only a small number of patients were tested for HIV infection, allowing ART to be provided to those few instances and resulting in a high rate of ART coverage. Peer-to-peer community-based HIV testing and the index-client testing approach were put into practice in Eswatini. Similarly, the “Botswana Combination Prevention Project” was an interventional trial conducted in Botswana. This project’s goal was to identify HIV-positive individuals who were not receiving ART and refer them to the ART clinics. Due to these circumstances, PLHIV were forced to start receiving ART in Botswana and Eswatini. Universal ART coverage in Australia reached 95%, but migrant populations had a lower ART coverage. Nearly all children with HIV were receiving ART in France, which is also making excellent progress [70]. This was explained by the fact that France has successfully implemented new HIV/AIDS policies [71]. In Oman [72], Afghanistan [73], Japan [74], and Mozambique [75], ART coverage was likewise reported to be higher than the global average point. The high rate of late HIV diagnosis in Oman may be the source of the reasonable rate of ART coverage, because to the accompanying opportunistic diseases, commencing ART is more likely if PLHIV were recently identified. Additionally, since 2015, the test and treat strategy may improve ART coverage in Oman, Afghanistan, and Mozambique.
A test and treat strategy on MSM was effective in China [76]. The 2021 UNAIDS report, however, showed a different result from the original finding in some countries. This could be because, first, many UNAIDS reports were HIV treatment cascades (percentage of PLHIV who started ART among all PLHIV), whereas most original research reported above 95% (the proportion of PLHIV who had started ART among PLHIV who knew their HIV status in the survey year). Second, the estimates in the UNAIDS study are modelled at the national level, which can occasionally differ from the actual issue at the regional or local level. Third, there is a current coverage gap between a particular research area and the national estimate (e.g., in Kazakhstan and South Africa). Fourth, the 2021 UNAIDS reports cover every age group, whereas some studies exclusively include adults (e.g., a study in Kazakhstan). Finally, there was variation in the survey year; ART coverage was higher in 2020 than it was in 2010 [24]. However, Georgia [77], Tanzania [78], and another study of South Africa [79] exhibited lower ART coverage rates. Before using the test and treat method, studies were carried out in Tanzania and Georgia. In South Africa, this was conducted among adolescent girls and young women. This age group has low ART coverage in most nations. Likewise, ART coverage was low among key populations (MSM, FSW, and drug users). These population groups experience significant levels of stigma or prejudice, which resulting in the reduced utilization of health service [80,81]. In both UNAIDS and research, key population’s ART coverage status was not well reported. There are countries where huge numbers of FSW with high HIV rates are living, but their ART coverage status is not recognized. For example, one out of five FSW had a confirmed diagnosis for HIV infection in Ethiopia [82], indicating a need for critical and urgent policy intervention.
Intervention programs in the community and at home help PLHIV to begin ART. When health services are embedded in the community, transportation costs are reduced, enabling patients to more readily afford HIV/AIDS-related services [83]. Membership to clubs and peer support groups raised awareness levels, offered emotional support, and helped with other administrative issues [84]. One of the key takeaways from the 2022 International AIDS Society conference conducted in Barcelona was that “communities with PLHIV continue to lead the way” because they can alter the community viewpoint in policy formulation and implementation [85].
A substantial proportion of PLHIV suffer from CHE, with the burden differing between nations. Financial assistance and insurance increased access to ART, but a greater percentage of PLHIV was prone to high health care expenses in Côte d’Ivoire [86], Ethiopia [87], Nigeria [58], India [62], and the Lao People’s Democratic Republic [64]. These numbers were unacceptably high for PLHIV who lived in rural areas, were far from a healthcare facility, had lower monthly income, and were illiterate and unemployed. The standard of HIV/AIDS care was also impaired by microeconomic factors [88]. Financial assistance for the poor, which includes increasing the country’s health insurance coverage, is an important strategy [38].
CHE and poverty were less well researched topics in financial protection. Less research was conducted on the equity dimension. In a similar vein, a bibliometric examination of HIV research found that equity concerns have received the least attention [89]. This might be due to researchers, the health department, and both public and commercial organizations being interested in determining the percentage of PLHIV on ART. This might motivate researchers to conduct more studies on ART coverage than equity. Despite this and the global push to achieve ART coverage, the required level of ART coverage has not yet been met, except in a few countries. This situation might encourage organizations to pay more attention to how social factors affect the equality of HIV/AIDS services [90].

5. Conclusions

Most studies concentrate on ART coverage and financial protection, while less evidence was on equity and quality of care. ART coverage was lower among the high HIV risk group, and disparities in ART coverage were common based on equity dimensions (ethnicity, sex, residence, and immigration status). People living with HIV in different countries were exposed to catastrophic costs, which were significantly higher among the poor, rural populations, and those living far from HIV clinics. Community-based interventions (peer and community support, home-based/door-to-door support, and membership) were effective strategies to improving ART coverage and the quality of care; effective leadership (presence of laws and monitoring) and financial strengthening (e.g., insurance) improved ART coverage. Health workforce strengthening improved the quality of care. Policy- and decisionmakers should consider challenges related to socioeconomic status, service delivery, health workforce, financing, and leadership if countries are really wanting to realize UHC.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/idr15010001/s1, Table S1: Search strategy, Table S2: Characteristics of articles.

Author Contributions

A.E.: conceptualization, identification of research questions, search strategy, literature research, write manuscript draft and final report; Y.A.: conceptualization, identification of research questions, search strategy, supervision, and approved the final manuscript; C.F.G.: supervision, revisions, and approved the final manuscript; F.A.: supervision, revisions, and approved the final manuscript; T.D.H.: revision and approved the final manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

The authors have not received funds to conduct this review.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

All the required data are available within the manuscript and supplementary files.

Conflicts of Interest

The authors declare that they have no conflict of interest.

References

  1. World Health Organization. Treating 3 Million by 2005: Making It Happen: The WHO Strategy: The WHO and UNAIDS Global Initiative to Provide Antiretroviral Therapy to 3 Million People with HIV/AIDS in Developing Countries by the End of 2005; World Health Organization: Geneva, Switzerland, 2003. [Google Scholar]
  2. UNAIDS. Global HIV & AIDS Statistics—Fact Sheet. 2021. Available online: https://www.unaids.org/en/resources/fact-sheet (accessed on 12 June 2022).
  3. Vos, T.; Lim, S.S.; Abbafati, C.; Abbas, K.M.; Abbasi, M.; Abbasifard, M.; Abbasi-Kangevari, M.; Abbastabar, H.; Abd-Allah, F.; Abdelalim, A.; et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020, 396, 1204–1222. [Google Scholar] [CrossRef] [PubMed]
  4. United Nations. United Nations Sustainable Development Summit 2015. 2015. Available online: https://sustainabledevelopment.un.org/post2015/summit (accessed on 21 August 2022).
  5. World Health Organization. Universal Health Coverage: Moving towards Better Health: Action Framework for the Western Pacific Region. 2016. Available online: https://www.who.int/publications/i/item/9789290617563 (accessed on 3 May 2022).
  6. Ng, M.; Fullman, N.; Dieleman, J.L.; Flaxman, A.D.; Murray, C.J.; Lim, S.S. Effective coverage: A metric for monitoring universal health coverage. PLoS Med. 2014, 11, e1001730. [Google Scholar] [CrossRef] [PubMed]
  7. World Health Organization; The World Bank Group. Tracking Universal Health Coverage: 2017 Global Monitoring Report; World Health Organization: Geneva, Switzerland, 2017. [Google Scholar]
  8. World Health Organization. Universal Health Coverage (UHC) 2021. Available online: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc) (accessed on 1 April 2022).
  9. World Health Organization. Standards for Quality HIV Care: A Tool for Quality Assessment, Improvement, and Accreditation; World Health Organization: Geneva, Switzerland, 2004. [Google Scholar]
  10. World Health Organization. Regional Office for The Eastern Mediterranean. Antiretroviral Therapy (ART) Coverage. 2019. Available online: https://rho.emro.who.int/Metadata/antiretroviral-therapy-art-coverage (accessed on 26 January 2022).
  11. World Health Organization. Maintaining and Improving Quality of Care within HIV Clinical Services; World Health Organization: Geneva, Switzerland, 2019. [Google Scholar]
  12. World Health Organization. Pushing for High-Quality HIV Services in Low- and Middle-Income Countries. 2019. Available online: https://www.who.int/news/item/04–10–2019-pushing-for-high-quality-hiv-services-in-low--and-middle-income-countries (accessed on 7 June 2022).
  13. World Health Organization; World Bank Group. Monitoring Progress towards Universal Health Coverage at Country and Global Levels: Framework, Measures and Targets; World Health Organization: Geneva, Switzerland, 2014. [Google Scholar]
  14. UNAIDS. World Health Organization. Guidance on Ethics and Equitable Access to HIV Treatment and Care; World Health Organization: Geneva, Switzerland, 2004. [Google Scholar]
  15. Joint United Nations Programme on HIV/AIDS. End Inequalities. End Aids. Global Aids Strategy 2021–2026. Available online: https://www.aidsdatahub.org/resource/end-inequalities-end-aids-global-aids-strategy-2021-2026 (accessed on 5 September 2022).
  16. Daudt, H.M.; van Mossel, C.; Scott, S.J. Enhancing the scoping study methodology: A large, inter-professional team’s experience with Arksey and O’Malley’s framework. BMC Med. Res. Methodol. 2013, 13, 48. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  17. Maulsby, C.H.; Ratnayake, A.; Hesson, D.; Mugavero, M.J.; Latkin, C.A. A scoping review of employment and HIV. AIDS Behav. 2020, 24, 2942–2955. [Google Scholar] [CrossRef] [PubMed]
  18. Saffier, I.P.; Kawa, H.; Harling, G. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil. BMC Infect. Dis. 2017, 17, 675. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  19. World Health Organization. Health Systems Financing: The Path to Universal Coverage; The World Health Report; World Health Organization: Geneva, Switzerland, 2010. [Google Scholar]
  20. Levac, D.; Colquhoun, H.; O’Brien, K.K. Scoping studies: Advancing the methodology. Implement. Sci. 2010, 5, 69. [Google Scholar] [CrossRef] [Green Version]
  21. Peters, M.D.J.; Marnie, C.; Tricco, A.C.; Pollock, D.; Munn, Z.; Alexander, L.; Mclnerney, P.; Godfrey, C.M.; Khalil, H. Updated methodological guidance for the conduct of scoping reviews. JBI Evid. Implement. 2021, 19, 3–10. [Google Scholar] [CrossRef]
  22. Arksey, H.; O’Malley, L. Scoping studies: Towards a methodological framework. Int. J. Soc. Res. Methodol. 2005, 8, 19–32. [Google Scholar] [CrossRef] [Green Version]
  23. Tricco, A.C.; Lillie, E.; Zarin, W.; O’Brien, K.K.; Colquhoun, H.; Levac, D.; Moher, D.; Peters, M.D.J.; Horsley, T.; Weeks, L.; et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann. Intern. Med. 2018, 169, 467–473. [Google Scholar] [CrossRef] [Green Version]
  24. UNAIDS. UNAIDS Data 2021 Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS. Available online: https://www.unaids.org/sites/default/files/media_asset/JC3032_AIDS_Data_book_2021_En.pdf (accessed on 11 October 2022).
  25. King, E.J.; Denebayeva, A.; Tukeyev, M.; Zhandybaeva, A.; Nurkerimova, A.; Nugmanova, Z. Factors associated with being on antiretroviral treatment among people living with HIV in Almaty, Kazakhstan. AIDS Care 2021, 33, 398–402. [Google Scholar] [CrossRef]
  26. Wirth, K.E.; Gaolathe, T.; Holme, M.P.; Mmalane, M.; Kadima, E.; Chakalisa, U.; Manyake, K.; Mbikiwa, A.M.; Simon, S.V.; Letlhogile, R.; et al. Population uptake of HIV testing, treatment, viral suppression, and male circumcision in Botswana: A cluster-randomized trial. Lancet HIV 2020, 7, e422. [Google Scholar] [CrossRef]
  27. Barnabas, R.V.; van Rooyen, H.; Tumwesigye, E.; Brantley, J.; Baeten, J.M.; van Heerden, A.; Turyamureeba, B.; Joseph, P.; Krows, M.; Thomas, K.K.; et al. Uptake of antiretroviral therapy and male circumcision after community-based HIV testing and strategies for linkage to care versus standard clinic referral: A multisite, open-label, randomised controlled trial in South Africa and Uganda. Lancet HIV 2016, 3, e212–e220. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  28. Floyd, S.; Shanaube, K.; Yang, B.; Schaap, A.; Griffith, S.; Phiri, M.; Macleod, D.; Sloot, R.; Sabapathy, K.; Bond, V.; et al. HIV testing and treatment coverage achieved after 4 years across 14 urban and peri-urban communities in Zambia and South Africa: An analysis of findings from the HPTN 071 (PopART) trial. PLoS Med. 2020, 17, e1003067. [Google Scholar] [CrossRef] [PubMed]
  29. Shanaube, K.; Macleod, D.; Chaila, M.J.; Mackworth-Young, C.; Hoddinott, G.; Schaap, A.; Floyd, S.; Bock, P.; Hayes, R.; Fidler, S.; et al. HIV care cascade among adolescents in a “Test and Treat” community-based intervention: HPTN 071 (PopART) for youth study. J. Adolesc. Health 2021, 68, 719–727. [Google Scholar] [CrossRef] [PubMed]
  30. Indravudh, P.P.; Fielding, K. Effect of community-led delivery of HIV self-testing on HIV testing and antiretroviral therapy initiation in Malawi: A cluster-randomised trial. PLoS Med. 2021, 18, e1003608. [Google Scholar] [CrossRef] [PubMed]
  31. Cornelius, L.J.; Erekaha, S.C.; Okundaye, J.N.; Sam-Agudu, N.A. A Socio-Ecological Examination of Treatment Access, Uptake and Adherence Issues Encountered By HIV-Positive Women in Rural North-Central Nigeria. J. Evid.-Inf. Soc. Work 2018, 15, 38–51. [Google Scholar] [CrossRef]
  32. Zelaya, C.E.; le Minh, N.; Lau, B.; Latkin, C.A.; Viet Ha, T.; Minh Quan, V.; Mo, T.T.; Sripaipan, T.; Davis, W.W.; Celentano, D.D.; et al. The Effect of a Multi-Level Intervention on the Initiation of Antiretroviral Therapy (ART) among HIV-Infected Men Who Inject Drugs and Were Diagnosed Late in Thai Nguyen, Vietnam. PLoS ONE 2016, 11, e0161718. [Google Scholar] [CrossRef] [Green Version]
  33. Karver, T.S.; Barrington, C.; Donastorg, Y.; Perez, M.; Gomez, H.; Page, K.R.; Celentano, D.; Smith, K.C.; Kerrigan, D. Exploring peer navigation and support in the quality of HIV care experiences of female sex workers in the Dominican Republic. BMC Health Serv. Res. 2022, 22, 56. [Google Scholar] [CrossRef]
  34. Iwuji, C.C.; Orne-Gliemann, J.; Larmarange, J. Uptake of Home-Based HIV Testing, Linkage to Care, and Community Attitudes about ART in Rural KwaZulu-Natal, South Africa: Descriptive Results from the First Phase of the ANRS 12249 TasP Cluster-Randomised Trial. PLoS Med. 2016, 13, e1002107. [Google Scholar] [CrossRef] [Green Version]
  35. Hayes, R.; Floyd, S.; Schaap, A.; Shanaube, K.; Bock, P.; Sabapathy, K.; Griffith, S.; Donnell, D.; Piwowar-Manning, E.; EI-Sadr, W.; et al. A universal testing and treatment intervention to improve HIV control: One-year results from intervention communities in Zambia in the HPTN 071 (PopART) cluster-randomised trial. PLoS Med. 2017, 14, e1002292. [Google Scholar] [CrossRef]
  36. Nascimento, L.; Paula, C.C.; Magnago, T.S.; Padoin, S.M.; Harzheim, E.; Silva, C.B. Quality of Primary Health Care for children and adolescents living with HIV. Proceedings of the National Academy of Sciences of the United States of America. Rev. Lat. Am. Enfermagem. 2016, 24, e2720. [Google Scholar] [CrossRef] [PubMed]
  37. Odayar, J.; Malaba, T.R.; Allerton, J.; Lesosky, M.; Myer, L. Delivery of antiretroviral therapy to HIV-infected women during the postpartum period: The Postpartum Adherence Clubs for Antiretroviral Therapy (PACART) trial. PLoS ONE 2019, 16, 100442. [Google Scholar] [CrossRef] [PubMed]
  38. Exavery, A. ART use and associated factors among HIV positive caregivers of orphans and vulnerable children in Tanzania. PLoS Med. 2020, 20, 1251. [Google Scholar] [CrossRef]
  39. Adeyinka, D.; Evans, M.; Ozigbu, C.; van Woerden, H.; Adeyinka, E.; Oladimeji, O.; Aimakhu, C.; Odoh, D.; Chamla, D. Understanding the influence of socioeconomic ernvironment on paediatric anti-retroviral treatment coverage: Towards closing treatment gaps in sub-Saharan Africa. Cent. Eur. J. Public Health 2017, 25, 55–63. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  40. Yeshiwas, Y.; Debie, A.; Worku, N.; Yazachew, L. Improving quality of service among antiretroviral therapy users through strategic problem-solving approach at bure primary hospital, northwest Ethiopia. Patient Prefer. Adherence 2021, 15, 1497–1504. [Google Scholar] [CrossRef] [PubMed]
  41. Visser, C.A.; Wolvaardt, J.E.; Cameron, D.; Marincowitz, G.J.O. Clinical mentoring to improve quality of care provided at three NIM-ART facilities: A mixed methods study. Afr. J. Prim. Health Care Fam. Med. 2018, 10, e1–e7. [Google Scholar] [CrossRef] [PubMed]
  42. Stecher, C. Physician network connections to specialists and HIV quality of care. Health Serv. Res. 2021, 56, 908–918. [Google Scholar] [CrossRef]
  43. Pilgrim, N.; Musheke, M.; Raymond, H.F.; Keating, R.; Mwale, J.; Banda, L.; Mulenga, D.; Phiri, L.; Geibel, S.; Tun, W. Quality of care and HIV service utilization among key populations in Zambia: A qualitative comparative analysis among female sex workers, men who have sex with men and people who use drugs. Aids Care-Psychol. Socio-Med. Asp. Aids/Hiv 2019, 31, 460–464. [Google Scholar] [CrossRef]
  44. Plazy, M.; Perriat, D.; Gumede, D.; Boyer, S.; Pillay, D.; Dabis, F.; Seeley, J.; Orne-Gliemann, J. Implementing universal HIV treatment in a high HIV prevalence and rural South African setting—Field experiences and recommendations of health care providers. PLoS ONE 2017, 12, e0186883. [Google Scholar] [CrossRef] [Green Version]
  45. Lazuardi, E.; Newman, C.E.; Anintya, I.; Rowe, E.; Wirawan, D.N.; Wisaksana, R.; Subronto, Y.W.; Kusmayanti, N.A.; Iskandar, S.; Kaldor, J. et al. Increasing HIV treatment access, uptake and use among men who have sex with men in urban Indonesia: Evidence from a qualitative study in three cities. Health Policy Plan. 2020, 35, 16–25. [Google Scholar]
  46. Li, C.Y.; Barrington, C.; Jiang, H.; Lei, G.; Golin, C.E.; Fisher, E.B.; Muessig, K.E. Challenges for accessing and maintaining good quality of HIV care among men who have sex with men living with HIV in China: A qualitative study with key stakeholders. Aids Care-Psychol. Socio-Med. Asp. Aids/Hiv 2020, 32, S119–S126. [Google Scholar] [CrossRef] [PubMed]
  47. Haacker, M.; Birungi, C. Poverty as a barrier to antiretroviral therapy access for people living with HIV/AIDS in Kenya. Afr. J. AIDS Res. 2018, 17, 145–152. [Google Scholar] [CrossRef] [PubMed]
  48. Cholong, B.J.; Mayin, K.B.; Aloysius, N.M. The Determinants of Catastrophic Health Expenditure and Coping Strategies for Households with People Living With HIV/AIDS in the Nkambe District Hospital, Cameroon. Eur. J. Health Sci. 2022, 7, 36–48. [Google Scholar] [CrossRef]
  49. Bousmah, M.A.; Nishimwe, M.L. Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: Evidence from Cameroon. BMC Health Serv. Res. 2021, 21, 313. [Google Scholar] [CrossRef]
  50. McClarty, L.M.; Blanchard, J.F.; Becker, M.L. Leaving no one behind? An equity analysis of the HIV care cascade among a cohort of people living with HIV in Manitoba, Canada. BMC Public Health 2021, 21, 281. [Google Scholar] [CrossRef]
  51. Rawat, A.; Uebel, K.; Moore, D.; Cingl, L.; Yassi, A. Patient Responses on Quality of Care and Satisfaction with Staff After Integrated HIV Care in South African Primary Health Care Clinics. J. Assoc. Nurses AIDS Care 2018, 29, 698–711. [Google Scholar] [CrossRef]
  52. Teeraananchai, S.; Kerr, S.J.; Khananuraksa, P.; Ruxrungtham, K.; Puthanakit, T. Rapid antiretroviral initiation among Thai youth living with HIV in the National AIDS programme in the era of treatment at any CD4 cell count: A national registry database study. J. Int. AIDS Soc. 2020, 23 (Suppl. S5), e25574. [Google Scholar] [CrossRef]
  53. Auld, A.F.; Shiraishi, R.W.; Mbofana, F.; Couto, A.; Fetogang, E.B.; El-Halabi, S.; Lebelonyane, R.; Pilatwe, P.T.; Humunime, N.; Okello, V.; et al. Lower levels of antiretroviral therapy enrollment among men with HIV compared with women—12 countries, 2002–2013. Morb. Mortal. Wkly. Rep. 2015, 64, 1281–1286. [Google Scholar] [CrossRef] [Green Version]
  54. Hoots, B.E.; Finlayson, T.J.; Wejnert, C.; Paz-Bailey, G.; Group, N.S. Early linkage to HIV care and antiretroviral treatment among men who have sex with men—20 cities, United States, 2008 and 2011. PLoS ONE 2015, 10, e0132962. [Google Scholar] [CrossRef] [Green Version]
  55. Landovitz, R.J.; Desmond, K.A.; Leibowitz, A.A. Antiretroviral Therapy: Racial Disparities among Publicly Insured Californians with HIV. J. Health Care Poor Underserved 2017, 28, 406–429. [Google Scholar] [CrossRef]
  56. Beer, L.; Bradley, H.; Mattson, C.L.; Johnson, C.H.; Hoots, B.; Shouse, R.L. Trends in racial and ethnic disparities in antiretroviral therapy prescription and viral suppression in the United States, 2009–2013. J. Acquir. Immune Defic. Syndr (1999) 2016, 73, 446. [Google Scholar] [CrossRef] [PubMed]
  57. Moyo, S.; Young, P.W.; Gouws, E.; Naidoo, I.; Wamicwe, J.; Mukui, I.; Marsh, K.; Igumbor, E.U.; Kim, A.A.; Rehle, T. Equity of antiretroviral treatment use in high HIV burden countries: Analyses of data from nationally-representative surveys in Kenya and South Africa. PLoS ONE 2018, 13, e0201899. [Google Scholar] [CrossRef]
  58. Onwujekwe, O.E.; Ibe, O.; Torpey, K.; Dada, S.; Uzochukwu, B.; Sanwo, O. Examining geographic and socio-economic differences in outpatient and inpatient consumer expenditures for treating HIV/AIDS in Nigeria. J. Int. AIDS Soc. 2016, 19, 20588. [Google Scholar] [CrossRef]
  59. Etiaba, E.; Onwujekwe, O.; Torpey, K.; Uzochukwu, B.; Chiegil, R. What Is the Economic Burden of Subsidized HIV/AIDS Treatment Services on Patients in Nigeria and Is This Burden Catastrophic to Households? PLoS ONE 2016, 11, e0167117. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  60. Negin, J.; Randell, M.; Raban, M.Z.; Nyirenda, M.; Kalula, S.; Madurai, L.; Kowal, P. Health expenditure and catastrophic spending among older adults living with HIV. Glob. Public Health 2017, 12, 1282–1296. [Google Scholar] [CrossRef] [PubMed]
  61. MacKenzie, L.J.; Hull, M.W.; Samji, H.; Lima, V.D.; Yip, B.; Zhang, W.; Lourenço, L.; Colley, G.; Hogg, R.S.; Montaner, J.S.G. Is there a rural/urban gap in the quality of HIV care for treatment-naive HIV-positive individuals initiating antiretroviral therapy in British Columbia? Aids Care-Psychol. Socio-Med. Asp. Aids/Hiv 2017, 29, 1218–1226. [Google Scholar] [CrossRef]
  62. Shukla, M.; Agarwal, M.; Singh, J.; Tripathi, A.; Srivastava, A.; Singh, V.K. Catastrophic health expenditure amongst people living with HIV/AIDS availing antiretroviral treatment services at two tertiary care health facilities in district of northern India. Indian J. Community Med. Off. Publ. Indian Assoc. Prev. Soc. Med. 2015, 6, 323–328. [Google Scholar]
  63. Alvi, Y.; Faizi, N.; Khalique, N.; Ahmad, A. Assessment of out-of-pocket and catastrophic expenses incurred by patients with Human Immunodeficiency Virus (HIV) in availing free antiretroviral therapy services in India. Public Health 2020, 183, 16–22. [Google Scholar] [CrossRef]
  64. Barennes, H.; Frichittavong, A.; Gripenberg, M.; Koffi, P. Evidence of High Out of Pocket Spending for HIV Care Leading to Catastrophic Expenditure for Affected Patients in Lao People’s Democratic Republic. PLoS ONE 2015, 10, e0136664. [Google Scholar] [CrossRef]
  65. Furuoka, F.; Hoque, M.Z. Determinants of antiretroviral therapy coverage in Sub-Saharan Africa. J. Int. AIDS Soc. 2015, 3, e1496. [Google Scholar] [CrossRef] [Green Version]
  66. Mnyaka, O.R.; Mabunda, S.A. Barriers to the Implementation of the HIV Universal Test and Treat Strategy in Selected Primary Care Facilities in South Africa’s Eastern Cape Province. J. Prim. Care Community Health 2021, 12, 21501327211028706. [Google Scholar] [CrossRef] [PubMed]
  67. Williams, D.; MacKellar, D. HIV testing and ART initiation among partners, family members, and high-risk associates of index clients participating in the CommLink linkage case management program, Eswatini, 2016–2018. PLoS ONE 2021, 16, e0261605. [Google Scholar] [CrossRef] [PubMed]
  68. Bachanas, P.; Alwano, M.G.; Lebelonyane, R.; Block, L.; Behel, S.; Raizes, E.; Ussery, G.; Wang, H.; Ussery, F.; Holme, M.P.; et al. Finding, treating and retaining persons with HIV in a high HIV prevalence and high treatment coverage country: Results from the Botswana Combination Prevention Project. PLoS ONE 2021, 16, e0250211. [Google Scholar] [CrossRef] [PubMed]
  69. Marukutira, T.; Gray, R.T.; Douglass, C.; El-Hayek, C.; Moreira, C.; Asselin, J.; Donovan, B.; Vickers, T.; Spelman, T.; Crowe, S.; et al. Gaps in the HIV diagnosis and care cascade for migrants in Australia, 2013–2017: A cross-sectional study. PLoS Med. 2020, 17, e1003044. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  70. Soumah, A.; Avettand-Fenoel, V.; Veber, F.; Moshous, D.; Mahlaoui, N.; Blanche, S.; Frange, P. High rates of antiretroviral coverage and virological suppression in HIV-1-infected children and adolescents. BMJ Open 2020, 50, 269–273. [Google Scholar] [CrossRef]
  71. KPMG. Ending the Epidemic: An Assessment of HIV Policy in France and Recommendation to Improve the Lives of Those Living with, and at Risk of HIV; KPMG: Amstelveen, The Netherlands, 2019. [Google Scholar]
  72. Elgalib, A.; Shah, S.; Al-Habsi, Z.; Al-Fouri, M.; Lau, R.; Al-Kindi, H.; Al-Rawahi, B.; Al-Abri, S. The cascade of HIV care in Oman, 2015–2018: A population-based study from the Middle East. Int. J. Infect. Dis. 2020, 90, 28–34. [Google Scholar] [CrossRef] [Green Version]
  73. Harooni, M.Z.; Atarud, A.A.; Ehsan, E.; Alokozai, A.; McFarland, W.; Mirzazadeh, A. Gaps in the continuum of care among people living with HIV in Afghanistan. Int. J. STD AIDS 2021, 33, 282–288. [Google Scholar] [CrossRef]
  74. Miyazaki, N.; Sugiura, W.; Gatanaga, H.; Watanabe, D.; Yamamoto, Y.; Yokomaku, Y.; Yoshimura, K.; Matsushita, S.; the Japanese HIV-MDR Study Group. The Prevalence of High Antiretroviral Coverage and Viral Suppression in Japan: An Excellent Profile for a Downstream Human Immunodeficiency Virus Care Spectrum. Jpn. J. Infect. Dis. 2017, 70, 158–160. [Google Scholar] [CrossRef] [Green Version]
  75. Pathmanathan, I.; Nelson, R.; de Louvado, A.; Thompson, R.; Pals, S.; Casavant, I.; Cardoso, M.J.A.; Ujamaa, D.; Bonzela, J.; Mikusova, S.; et al. High Coverage of Antiretroviral Treatment with Annual Home-Based HIV Testing, Follow-up Linkage Services, and Implementation of Test and Start: Findings From the Chokwe Health Demographic Surveillance System, Mozambique, 2014–2019. Jaids-J. Acquir. Immune Defic. Syndr. 2021, 86, E97–E105. [Google Scholar] [CrossRef]
  76. Wu, C.; Zhang, B.; Dai, Z.; Zheng, Q.; Duan, Z.; He, Q.; Zhu, C. Impact of immediate initiation of antiretroviral therapy among men who have sex with men infected with HIV in Chengdu, southwest China: Trends analysis, 2008–2018. BMC Public Health 2021, 21, 689. [Google Scholar] [CrossRef]
  77. Chkhartishvili, N.; Chokoshvili, O.; Dvali, N.; Abutidze, A.; Sharvadze, L.; Tsertsvadze, T. Significant Improvements Are Needed in HIV Care Continuum to Meet 90–90–90 Targets in Georgia. J. Int. Assoc. Provid. AIDS Care 2016, 15, 451–454. [Google Scholar] [CrossRef] [PubMed]
  78. Levira, F.; Agnarson, A.M.; Masanja, H.; Zaba, B.; Ekström, A.M.; Thorson, A. Antiretroviral treatment coverage in a rural district in Tanzania—A modeling study using empirical data. BMC Public Health 2015, 15, 195. [Google Scholar] [CrossRef] [PubMed]
  79. Mathews, C.; Cheyip, M.; Beauclair, R.; Puren, A.; Lombard, C.; Jonas, K.; Ayalew, K.A.; Govindasamy, D.; Kuo, C.; Dietrich., J.J.; et al. HIV care coverage among HIV-positive adolescent girls and young women in South Africa: Results from the HERStory Study. S. Afr. Med. J. 2021, 111, 460–468. [Google Scholar] [CrossRef]
  80. Ruegsegger, L.M.; Stockton, M.; Go, V.F.; Piscalko, H.; Davis, D.; Hoffman, I.F.; Hosseinipour, M.C.; Zalira, E.; Lungu, T.; Bula, A.; et al. Stigma, Social Support, and Sexual Behavior among Female Sex Workers at risk for HIV in Malawi. AIDS Educ. Prev. Off. Publ. Int. Soc. AIDS Educ. 2021, 33, 290. [Google Scholar] [CrossRef] [PubMed]
  81. Ferraz, D.; Couto, M.T.; Zucchi, E.M.; Calazans, G.J.; dos Santos, L.A.; Mathias, A.; Grangeiro, A. AIDS-and sexuality-related stigmas underlying the use of post-exposure prophylaxis for HIV in Brazil: Findings from a multicentric study. Sex. Reprod. Health Matters 2019, 27, 107–121. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  82. Abdella, S.; Demissie, M.; Worku, A.; Dheresa, M.; Berhane, Y. HIV prevalence and associated factors among female sex workers in Ethiopia, east Africa: A cross-sectional study using a respondent-driven sampling technique. EClinicalMedicine 2022, 51, 101540. [Google Scholar] [CrossRef]
  83. Sharma, M.; Smith, J.A.; Farquhar, C.; Ying, R.; Cherutich, P.; Golden, M.; Wamuti, B.; Bukusi, D.; Spiegel, H.; Barnabas, R.V. Assisted partner notification services are cost-effective for decreasing HIV burden in western Kenya. Aids 2018, 32, 233–241. [Google Scholar] [CrossRef]
  84. Iryawan, A.R.; Stoicescu, C.; Sjahrial, F.; Nio, K.; Dominich, A. The impact of peer support on testing, linkage to and engagement in HIV care for people who inject drugs in Indonesia: Qualitative perspectives from a community-led study. Harm Reduct. J. 2022, 19, 16. [Google Scholar] [CrossRef] [PubMed]
  85. Corina, M. Four takeaways from the AIDS 2022 Conference: Clinton Health Access Initiative. 2022. Available online: https://www.clintonhealthaccess.org/blog/4-takeaways-from-aids-2022/ (accessed on 19 September 2022).
  86. Stelmach, R.D.; Rabkin, M.; Abo, K.; Ahoba, I.; Gildas Anago, M.; Boccanera, R.; Brou, H.; Flueckiger, R.; Hartsough, K.; Msukwa, M.; et al. Financial burdens of HIV and chronic disease on people living with HIV in Côte d’Ivoire: A cross-sectional out-of-pocket expenditure study. PLoS ONE 2021, 16, e0255074. [Google Scholar] [CrossRef]
  87. Assebe, L.F.; Negussie, E.K.; Jbaily, A.; Tolla, M.T.T.; Johansson, K.A. Financial burden of HIV and TB among patients in Ethiopia: A cross-sectional survey. BMJ Open 2020, 10, e036892. [Google Scholar] [CrossRef]
  88. Julien, A.; Anthierens, S.; van Rie, A.; West, R.; Maritze, M.; Twine, R.; Kahn, K.; Lippman, S.S.; Pettifor, A.; Leslie, H.H. Health Care Providers’ Challenges to High-Quality HIV Care and Antiretroviral Treatment Retention in Rural South Africa. Qual. Health Res. 2021, 31, 722–735. [Google Scholar] [CrossRef] [PubMed]
  89. Aves, T.; Kredo, T.; Welch, V.; Mursleen, S.; Ross, S.; Zani, B.; Motaze, N.V.; Quinlan, L.; Mbugbaw, L. Equity issues were not fully addressed in Cochrane human immunodeficiency virus systematic reviews. J. Clin. Epidemiol. 2017, 81, 96–100. [Google Scholar] [CrossRef] [PubMed]
  90. Dover, D.C.; Belon, A.P. The health equity measurement framework: A comprehensive model to measure social inequities in health. Int. J. Equity Health 2019, 18, 36. [Google Scholar] [CrossRef] [PubMed]
Idr 15 00001 g001 550
Figure 1. PRISMA flow diagram for the article selection process.
Figure 1. PRISMA flow diagram for the article selection process.
Idr 15 00001 g001
Idr 15 00001 g002 550
Figure 2. Research production of UHC dimensions on ART from January 2015 to March 2022.
Figure 2. Research production of UHC dimensions on ART from January 2015 to March 2022.
Idr 15 00001 g002
Idr 15 00001 g003 550
Figure 3. ART coverage based on research findings by survey year and UNAIDS 2021 report for all age groups.
Figure 3. ART coverage based on research findings by survey year and UNAIDS 2021 report for all age groups.
Idr 15 00001 g003
Idr 15 00001 g004 550
Figure 4. Percentage of ART coverage among key populations (drug users, female sex workers/FSW, and male who has sex with male/MSM) based on available research with survey year and the 2021 UNAIDS report for key population and all ages.
Figure 4. Percentage of ART coverage among key populations (drug users, female sex workers/FSW, and male who has sex with male/MSM) based on available research with survey year and the 2021 UNAIDS report for key population and all ages.
Idr 15 00001 g004
Idr 15 00001 g005 550
Figure 5. Percentage of catastrophic health expenditure in different countries based on threshold (10% and 40%), the department (IP: inpatient and OP: outpatient), and survey year.
Figure 5. Percentage of catastrophic health expenditure in different countries based on threshold (10% and 40%), the department (IP: inpatient and OP: outpatient), and survey year.
Idr 15 00001 g005
Table
Table 1. Strategies (✓) that enhance the ART coverage and quality of care.
Table 1. Strategies (✓) that enhance the ART coverage and quality of care.
StrategiesCoverageQuality of Care
Diagnosed after the country’s change in treatment approach [25]✓
Community-based HIV prevention and treatment interventions (test and treat) [26,27,28,29,30]✓
Peer (group) and community support [31,32,33]✓✓
Home-based care, including door-to-door communication [32,34,35]✓
Family health strategy [36] ✓
Being a member of adherence clubs of HIV-positive people [37]✓
Health insurance [38]✓
Food security [38]✓
Government expenditure on health [39]✓
Effective governance [39]✓
Virology testing by 2 months of age [39]✓
Density of healthcare workers per 10,000 population [39]✓
Presence of laws to combat barriers [31]✓
Ensuring regular internal mentorship [40,41]✓✓
Availing supplies [40] ✓
Providing refresher training [40] ✓
Physician network connectedness [42] ✓
Comfort in the clinic [43] ✓
Table
Table 2. Barriers (✓) for ART coverage, catastrophic health expenditure and quality of care.
Table 2. Barriers (✓) for ART coverage, catastrophic health expenditure and quality of care.
BarriersCoverageCatastrophic Health ExpenditureQuality of Care
Logistical problems [44]✓
ART shortage [31,44,45]✓
Workload [41,44,46]✓ ✓
Shortage of trained health force [41,46] ✓
Poverty [47]✓
Stigma and discrimination [31,43,46]✓ ✓
Long waiting times in ART clinic [31]✓
Transportation unavailability [31]✓
Cost problems [31]✓
Clients fear of unwanted disclosure [45]✓
Mode of transportation (motor cycle) than private car [48] ✓
Implementation of the free ART policy in middle income [49] ✓
Lack of confidentiality [43] ✓
Legal prosecution [43] ✓
Poor infrastructure [41] ✓
Unclear division of responsibility between health care providers [46] ✓
Limited training opportunity [46] ✓
Strict auditing [46] ✓
Table
Table 3. Socio-demographic and clinical-related factors (✓) for ART coverage, catastrophic health expenditure, and quality of care.
Table 3. Socio-demographic and clinical-related factors (✓) for ART coverage, catastrophic health expenditure, and quality of care.
DeterminantsMore Covered (Inequity)High Catastrophic Health ExpenditurePoor Quality of Care
Caregivers aged 40–49 years [38]✓
Older [50,51]✓ ✓
Age 15–19 years [52]✓
Age 18–25 and 36–45 years [51]✓ ✓
Female [51,52,53]✓ ✓
White vs. Black [50,54,55,56]✓
Urban dwellers [38,57]✓
Rural residence [58,59,60,61] ✓✓
Lives far distance from health care settings [62,63,64] ✓
Divorced adult [48] ✓
Non-immigrants vs. immigrants [50]✓
Educated [38]✓
Being unemployed [63] ✓
Lower socioeconomic class [59,62,63,64] ✓
Belonged to nuclear family [63] ✓
Non-disabled vs. disabled [38]✓
Live in high HIV burden area [65]✓
Acquired HIV through sexual transmission rather than injection drug users [25]✓
Diagnosed in later clinical stages [25]✓
Had a CD4 cell count lower than 200 [63] ✓
Attending clinic more than 10 years [51] ✓
Visiting clinics every 3 months [51] ✓
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Endalamaw, A.; Gilks, C.F.; Ambaw, F.; Habtewold, T.D.; Assefa, Y. Universal Health Coverage for Antiretroviral Treatment: A Review. Infect. Dis. Rep. 2023, 15, 1-15. https://doi.org/10.3390/idr15010001

AMA Style

Endalamaw A, Gilks CF, Ambaw F, Habtewold TD, Assefa Y. Universal Health Coverage for Antiretroviral Treatment: A Review. Infectious Disease Reports. 2023; 15(1):1-15. https://doi.org/10.3390/idr15010001

Chicago/Turabian Style

Endalamaw, Aklilu, Charles F Gilks, Fentie Ambaw, Tesfa Dejenie Habtewold, and Yibeltal Assefa. 2023. "Universal Health Coverage for Antiretroviral Treatment: A Review" Infectious Disease Reports 15, no. 1: 1-15. https://doi.org/10.3390/idr15010001

Article Metrics

Back to TopTop