A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

TY - JOUR

T1 - A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

AU - Jopling, Rebecca

AU - Nyamayaro, Primrose

AU - Andersen, Lena S.

AU - Kagee, Ashraf

AU - Haberer, Jessica E.

AU - Abas, Melanie Amna

PY - 2020/10/1

Y1 - 2020/10/1

N2 - Purpose of Review: We reviewed interventions to improve uptake and adherence to antiretroviral therapy (ART) in African countries in the Treat All era. Recent Findings: ART initiation can be improved by facilitated rapid receipt of first prescription, including community-based linkage and point-of-care strategies, integration of HIV care into antenatal care and peer support for adolescents. For people living with HIV (PLHIV) on ART, scheduled SMS reminders, ongoing intensive counselling for those with viral non-suppression and economic incentives for the most deprived show promise. Adherence clubs should be promoted, being no less effective than facility-based care for stable patients. Tracing those lost to follow-up should be targeted to those who can be seen face-to-face by a peer worker. Summary: Investment is needed to promote linkage to initiating ART and for differentiated approaches to counselling for youth and for those with identified suboptimal adherence. More evidence from within Africa is needed on cost-effective strategies to identify and support PLHIV at an increased risk of non-adherence across the treatment cascade.

AB - Purpose of Review: We reviewed interventions to improve uptake and adherence to antiretroviral therapy (ART) in African countries in the Treat All era. Recent Findings: ART initiation can be improved by facilitated rapid receipt of first prescription, including community-based linkage and point-of-care strategies, integration of HIV care into antenatal care and peer support for adolescents. For people living with HIV (PLHIV) on ART, scheduled SMS reminders, ongoing intensive counselling for those with viral non-suppression and economic incentives for the most deprived show promise. Adherence clubs should be promoted, being no less effective than facility-based care for stable patients. Tracing those lost to follow-up should be targeted to those who can be seen face-to-face by a peer worker. Summary: Investment is needed to promote linkage to initiating ART and for differentiated approaches to counselling for youth and for those with identified suboptimal adherence. More evidence from within Africa is needed on cost-effective strategies to identify and support PLHIV at an increased risk of non-adherence across the treatment cascade.

KW - Adherence

KW - Antiretroviral therapy (ART)

KW - ART initiation

KW - HIV

KW - Interventions

KW - Retention in care

KW - Review

UR - http://www.scopus.com/inward/record.url?scp=85089257739&partnerID=8YFLogxK

U2 - 10.1007/s11904-020-00511-4

DO - 10.1007/s11904-020-00511-4

M3 - Review article

C2 - 32776179

AN - SCOPUS:85089257739

SN - 1548-3568

VL - 17

SP - 529

EP - 546

JO - Current HIV/AIDS Reports

JF - Current HIV/AIDS Reports

IS - 5

ER -