Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: Results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

Stephany N. Duda*, Amanda M. Farr, Mary Lou Lindegren, Meridith Blevins, C. William Wester, Kara Wools-Kaloustian, Didier K. Ekouevi, Matthias Egger, Jennifer Hemingway-Foday, David A. Cooper, Richard D. Moore, Catherine C. McGowan, Denis Nash, Vonthanak Saphonn, Sarun Saramony, Ning Han, Man Po Lee, Fujie Zhang, Vivek Bele, Sanjay PujariTuti Merati, Okki Ramadian, Flora Yuliana, Evy Yunihastuti, Shinichi Oka, Misao Takano, Anna Kajindran, Adeeba Kamarulzaman, Lee Lee Low, Benedict L H Sim, Rowena Capistrano, Rossana Ditangco, Lou Hui Kuo, Wing Wai Wong, Romanee Chaiwarith, Mana Khongpattanayothin, Sasisopin Kiertiburanakul, Wilai Kotarathititum, Praphan Phanuphak, Bucha Piyavong, Estelle Fou, Oon Tek Ng, Jun Yong Choi, Sang Hoon Han, Andrew Carr, John Chuah, Bridget Dickson, Jennifer Hoy, Jing Ji, Firas Wehbe, the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

*Corresponding author for this work

    Research output: Contribution to journalArticle

    29 Citations (Scopus)

    Abstract

    Introduction: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results: Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. Conclusions: This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.

    Original languageEnglish (US)
    Article number19045
    JournalJournal of the International AIDS Society
    Volume17
    Issue number1
    DOIs
    StatePublished - Jan 1 2014

    Fingerprint

    Africa South of the Sahara
    Acquired Immunodeficiency Syndrome
    HIV
    Databases
    Human Development
    Therapeutics
    Tuberculosis
    Community-Institutional Relations
    Contact Tracing
    Central Africa
    Southern Africa
    Eastern Africa
    Western Africa
    Nutritional Support
    Latin America
    United Nations
    Social Welfare
    Quality of Health Care
    Isoniazid
    CD4 Lymphocyte Count

    Keywords

    • Clinic characteristics
    • Comprehensive care
    • HIV care capacity
    • HIV/AIDS
    • Resource-limited settings

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health
    • Infectious Diseases

    Cite this

    Duda, Stephany N. ; Farr, Amanda M. ; Lindegren, Mary Lou ; Blevins, Meridith ; Wester, C. William ; Wools-Kaloustian, Kara ; Ekouevi, Didier K. ; Egger, Matthias ; Hemingway-Foday, Jennifer ; Cooper, David A. ; Moore, Richard D. ; McGowan, Catherine C. ; Nash, Denis ; Saphonn, Vonthanak ; Saramony, Sarun ; Han, Ning ; Lee, Man Po ; Zhang, Fujie ; Bele, Vivek ; Pujari, Sanjay ; Merati, Tuti ; Ramadian, Okki ; Yuliana, Flora ; Yunihastuti, Evy ; Oka, Shinichi ; Takano, Misao ; Kajindran, Anna ; Kamarulzaman, Adeeba ; Low, Lee Lee ; Sim, Benedict L H ; Capistrano, Rowena ; Ditangco, Rossana ; Kuo, Lou Hui ; Wong, Wing Wai ; Chaiwarith, Romanee ; Khongpattanayothin, Mana ; Kiertiburanakul, Sasisopin ; Kotarathititum, Wilai ; Phanuphak, Praphan ; Piyavong, Bucha ; Fou, Estelle ; Ng, Oon Tek ; Choi, Jun Yong ; Han, Sang Hoon ; Carr, Andrew ; Chuah, John ; Dickson, Bridget ; Hoy, Jennifer ; Ji, Jing ; Wehbe, Firas ; the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration. / Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas : Results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration. In: Journal of the International AIDS Society. 2014 ; Vol. 17, No. 1.
    @article{b5ea85a331e54665b34f303f27497258,
    title = "Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: Results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration",
    abstract = "Introduction: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results: Most sites reported serving urban (61{\%}; region range (rr): 33-100{\%}) and both adult and paediatric populations (77{\%}; rr: 29-96{\%}). Only 45{\%} of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72{\%}, respectively. The remaining four essential services - nutritional support (82{\%}), combination antiretroviral therapy adherence support (88{\%}), prevention of mother-to-child transmission (PMTCT) (94{\%}) and other prevention and clinical management services (97{\%}) - were uniformly available. Approximately half (46{\%}) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. Conclusions: This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.",
    keywords = "Clinic characteristics, Comprehensive care, HIV care capacity, HIV/AIDS, Resource-limited settings",
    author = "Duda, {Stephany N.} and Farr, {Amanda M.} and Lindegren, {Mary Lou} and Meridith Blevins and Wester, {C. William} and Kara Wools-Kaloustian and Ekouevi, {Didier K.} and Matthias Egger and Jennifer Hemingway-Foday and Cooper, {David A.} and Moore, {Richard D.} and McGowan, {Catherine C.} and Denis Nash and Vonthanak Saphonn and Sarun Saramony and Ning Han and Lee, {Man Po} and Fujie Zhang and Vivek Bele and Sanjay Pujari and Tuti Merati and Okki Ramadian and Flora Yuliana and Evy Yunihastuti and Shinichi Oka and Misao Takano and Anna Kajindran and Adeeba Kamarulzaman and Low, {Lee Lee} and Sim, {Benedict L H} and Rowena Capistrano and Rossana Ditangco and Kuo, {Lou Hui} and Wong, {Wing Wai} and Romanee Chaiwarith and Mana Khongpattanayothin and Sasisopin Kiertiburanakul and Wilai Kotarathititum and Praphan Phanuphak and Bucha Piyavong and Estelle Fou and Ng, {Oon Tek} and Choi, {Jun Yong} and Han, {Sang Hoon} and Andrew Carr and John Chuah and Bridget Dickson and Jennifer Hoy and Jing Ji and Firas Wehbe and {the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration}",
    year = "2014",
    month = "1",
    day = "1",
    doi = "10.7448/IAS.17.1.19045",
    language = "English (US)",
    volume = "17",
    journal = "Journal of the International AIDS Society",
    issn = "1758-2652",
    publisher = "International AIDS Society",
    number = "1",

    }

    Duda, SN, Farr, AM, Lindegren, ML, Blevins, M, Wester, CW, Wools-Kaloustian, K, Ekouevi, DK, Egger, M, Hemingway-Foday, J, Cooper, DA, Moore, RD, McGowan, CC, Nash, D, Saphonn, V, Saramony, S, Han, N, Lee, MP, Zhang, F, Bele, V, Pujari, S, Merati, T, Ramadian, O, Yuliana, F, Yunihastuti, E, Oka, S, Takano, M, Kajindran, A, Kamarulzaman, A, Low, LL, Sim, BLH, Capistrano, R, Ditangco, R, Kuo, LH, Wong, WW, Chaiwarith, R, Khongpattanayothin, M, Kiertiburanakul, S, Kotarathititum, W, Phanuphak, P, Piyavong, B, Fou, E, Ng, OT, Choi, JY, Han, SH, Carr, A, Chuah, J, Dickson, B, Hoy, J, Ji, J, Wehbe, F & the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration 2014, 'Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: Results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration', Journal of the International AIDS Society, vol. 17, no. 1, 19045. https://doi.org/10.7448/IAS.17.1.19045

    Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas : Results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration. / Duda, Stephany N.; Farr, Amanda M.; Lindegren, Mary Lou; Blevins, Meridith; Wester, C. William; Wools-Kaloustian, Kara; Ekouevi, Didier K.; Egger, Matthias; Hemingway-Foday, Jennifer; Cooper, David A.; Moore, Richard D.; McGowan, Catherine C.; Nash, Denis; Saphonn, Vonthanak; Saramony, Sarun; Han, Ning; Lee, Man Po; Zhang, Fujie; Bele, Vivek; Pujari, Sanjay; Merati, Tuti; Ramadian, Okki; Yuliana, Flora; Yunihastuti, Evy; Oka, Shinichi; Takano, Misao; Kajindran, Anna; Kamarulzaman, Adeeba; Low, Lee Lee; Sim, Benedict L H; Capistrano, Rowena; Ditangco, Rossana; Kuo, Lou Hui; Wong, Wing Wai; Chaiwarith, Romanee; Khongpattanayothin, Mana; Kiertiburanakul, Sasisopin; Kotarathititum, Wilai; Phanuphak, Praphan; Piyavong, Bucha; Fou, Estelle; Ng, Oon Tek; Choi, Jun Yong; Han, Sang Hoon; Carr, Andrew; Chuah, John; Dickson, Bridget; Hoy, Jennifer; Ji, Jing; Wehbe, Firas; the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration.

    In: Journal of the International AIDS Society, Vol. 17, No. 1, 19045, 01.01.2014.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas

    T2 - Results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

    AU - Duda, Stephany N.

    AU - Farr, Amanda M.

    AU - Lindegren, Mary Lou

    AU - Blevins, Meridith

    AU - Wester, C. William

    AU - Wools-Kaloustian, Kara

    AU - Ekouevi, Didier K.

    AU - Egger, Matthias

    AU - Hemingway-Foday, Jennifer

    AU - Cooper, David A.

    AU - Moore, Richard D.

    AU - McGowan, Catherine C.

    AU - Nash, Denis

    AU - Saphonn, Vonthanak

    AU - Saramony, Sarun

    AU - Han, Ning

    AU - Lee, Man Po

    AU - Zhang, Fujie

    AU - Bele, Vivek

    AU - Pujari, Sanjay

    AU - Merati, Tuti

    AU - Ramadian, Okki

    AU - Yuliana, Flora

    AU - Yunihastuti, Evy

    AU - Oka, Shinichi

    AU - Takano, Misao

    AU - Kajindran, Anna

    AU - Kamarulzaman, Adeeba

    AU - Low, Lee Lee

    AU - Sim, Benedict L H

    AU - Capistrano, Rowena

    AU - Ditangco, Rossana

    AU - Kuo, Lou Hui

    AU - Wong, Wing Wai

    AU - Chaiwarith, Romanee

    AU - Khongpattanayothin, Mana

    AU - Kiertiburanakul, Sasisopin

    AU - Kotarathititum, Wilai

    AU - Phanuphak, Praphan

    AU - Piyavong, Bucha

    AU - Fou, Estelle

    AU - Ng, Oon Tek

    AU - Choi, Jun Yong

    AU - Han, Sang Hoon

    AU - Carr, Andrew

    AU - Chuah, John

    AU - Dickson, Bridget

    AU - Hoy, Jennifer

    AU - Ji, Jing

    AU - Wehbe, Firas

    AU - the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

    PY - 2014/1/1

    Y1 - 2014/1/1

    N2 - Introduction: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results: Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. Conclusions: This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.

    AB - Introduction: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results: Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. Conclusions: This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.

    KW - Clinic characteristics

    KW - Comprehensive care

    KW - HIV care capacity

    KW - HIV/AIDS

    KW - Resource-limited settings

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