Journal
JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED
Volume 24, Issue 1, Pages 359-383Publisher
JOHNS HOPKINS UNIV PRESS
DOI: 10.1353/hpu.2013.0014
Keywords
Late ART initiation; sub-Saharan Africa; scale-up; conceptual framework; retention
Funding
- NIMH NIH HHS [R01 MH089831, P30 MH043520] Funding Source: Medline
Ask authors/readers for more resources
Efforts to scale-up HIV care and treatment have been successful at initiating large numbers of patients onto antiretroviral therapy (ART), although persistent challenges remain to optimizing scale-up effectiveness in both resource-rich and resource-limited settings. Among the most important are very high rates of ART initiation in the advanced stages of HIV disease, which in turn drive morbidity, mortality, and onward transmission of HIV. With a focus on sub-Saharan Africa, this review article presents a conceptual framework for a broader discussion of the persistent problem of late ART initiation, including a need for more focus on the upstream precursors (late HIV diagnosis and late enrollment into HIV care) and their determinants. Without additional research and identification of multi-level interventions that successfully promote earlier initiation of ART, the problem of late ART initiation will persist, significantly undermining the long-term impact of HIV care scale-up on reducing mortality and controlling the HIV epidemic.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available