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Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings

dc.contributor.authorSpaar A.
dc.contributor.authorGraber C.
dc.contributor.authorDabis F.
dc.contributor.authorCoutsoudis A.
dc.contributor.authorBachmann L.
dc.contributor.authorMcIntyre J.
dc.contributor.authorSchechter M.
dc.contributor.authorProzesky H.W.
dc.contributor.authorTuboi S.
dc.contributor.authorDickinson D.
dc.contributor.authorKumarasamy N.
dc.contributor.authorPujdades-Rodriquez M.
dc.contributor.authorSprinz E.
dc.contributor.authorSchilthuis H.J.
dc.contributor.authorCahn P.
dc.contributor.authorLow N.
dc.contributor.authorEgger M.
dc.date.accessioned2011-05-15T16:15:15Z
dc.date.available2011-05-15T16:15:15Z
dc.date.issued2010
dc.identifier.citationAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
dc.identifier.citation22
dc.identifier.citation6
dc.identifier.issn09540121
dc.identifier.other10.1080/09540120903349102
dc.identifier.urihttp://hdl.handle.net/10019.1/13258
dc.description.abstractExpanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to-child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely. © 2010 Taylor & Francis.
dc.subjectefavirenz
dc.subjectlamivudine
dc.subjectnevirapine
dc.subjectzidovudine
dc.subjectarticle
dc.subjectAsia
dc.subjectBotswana
dc.subjectBrazil
dc.subjectBurundi
dc.subjectcondom
dc.subjectCongo
dc.subjectcounseling
dc.subjectfunding
dc.subjecthealth care planning
dc.subjecthealth education
dc.subjecthealth program
dc.subjecthighly active antiretroviral therapy
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectIndia
dc.subjectinterpersonal communication
dc.subjectMorocco
dc.subjectNigeria
dc.subjectpriority journal
dc.subjectRwanda
dc.subjectsex role
dc.subjectsexually transmitted disease
dc.subjectsingle drug dose
dc.subjectsocial support
dc.subjectSouth Africa
dc.subjectSouth America
dc.subjectstigma
dc.subjectThailand
dc.subjectUganda
dc.subjecturban area
dc.subjectvertical transmission
dc.subjectZambia
dc.subjectZimbabwe
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAfrica
dc.subjectAnti-Retroviral Agents
dc.subjectAsia
dc.subjectChild
dc.subjectCondoms
dc.subjectCounseling
dc.subjectDelivery of Health Care
dc.subjectFemale
dc.subjectHealth Education
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectInfant
dc.subjectInfant, Newborn
dc.subjectInfectious Disease Transmission, Vertical
dc.subjectMale
dc.subjectPatient Education as Topic
dc.subjectPreventive Health Services
dc.subjectProgram Evaluation
dc.subjectQuestionnaires
dc.subjectSocial Support
dc.subjectSouth America
dc.titlePrioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings
dc.typeArticle
dc.description.versionArticle


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