TITLE

Is there a role for primary care clinicians in providing shared care in HIV treatment? A systematic literature review

AUTHOR(S)
W. C. W. Wong; C. W. Luk; Kidd, M. R.
PUB. DATE
March 2012
SOURCE
Sexually Transmitted Infections;Mar2012, Vol. 88 Issue 2, p125
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background Despite HIV being increasingly considered as a chronic illness, there is as yet no consensus about how primary care should be integrated with specialty care to provide optimal clinical management for people living with HIV. Objective To examine the effectiveness of shared care models of HIV between primary care and specialty care and how primary care providers can assist in improving the care of people with HIV. Methods Three databases, PubMed, Medline and EMBase, were searched for relevant terms from studies published in the period from 1996 to 2011. Studies that integrated primary care in HIV management and included highly active antiretroviral therapy (HAART) as part of the treatment modality were included. Results Eleven studies that met the inclusion criteria were included in this review. Primary care was found to be at least as effective in HIV counselling, testing and treatment and, to a lesser degree, prevention, when compared with specialty care alone. Screening for HIV at a primary care level was cost-effective, especially in a high HIV prevalence and high-risk community. There were no significant adverse clinical outcomes reported in a primary care approach. Effectiveness of various interventions using a primary care approach was demonstrated in the review, including HAART adherence programmes, home care, the involvement of peer health workers and perinatal use of HAART. Conclusions Primary care has an important role in the shared care of the diagnosis and management of people with HIV. Some improvements with current guidelines on the management in primary care of people with HIV in developing countries should be considered.
ACCESSION #
93477416

 

Related Articles

  • People with AIDS (PWA) Since Highly Active Antiretroviral Therapy, 1996. Dunbar, Deanne // Journal of Medical Humanities;Jun2011, Vol. 32 Issue 2, p115 

    lthough clarity about HIV transmission biology and effective therapy should mean that an AIDS diagnosis is more socially acceptable today, for some groups the cultural stigma of HIV infection has changed little in the last 30 years. This paper will examine why representations of HIV-positive gay...

  • Antiretroviral Therapy as HIV Prevention: Status and Prospects. Mayer, Kenneth H.; Venkatesh, Kartik K. // American Journal of Public Health;Oct2010, Vol. 100 Issue 10, p1867 

    As antiretroviral treatment of HIV infection has become increasingly accessible, attention has focused on whether these drugs can used for prevention because of increased tolerability of newer medications, decreased cost, and the limitations of other approaches. We review the status of...

  • Healthcare utilization of patients accessing an African national treatment program. Harling, Guy; Orrell, Catherine; Wood, Robin // BMC Health Services Research;2007, Vol. 7, p80 

    Background: The roll-out of antiretroviral therapy (ART) in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when...

  • Metabolic and Skeletal Complications of HIV Infection. Morse, Caryn G.; Kovacs, Joseph A. // JAMA: Journal of the American Medical Association;8/16/2006, Vol. 296 Issue 7, p844 

    Over the past 10 years, in conjunction with the broad availability of potent antiretroviral regimens, the care of human immunodeficiency virus (HIV)-infected patients has shifted from prevention and treatment of opportunistic infections and malignancies to management of the metabolic and related...

  • Review of antiretroviral agents for the treatment of HIV infection. Stanic, Anela; Grana, Julie C. // Formulary;Feb2009, Vol. 44 Issue 2, p47 

    Research into the treatment of HIV infection has resulted in the development of 5 antiretroviral (ARV) drug classes: entry inhibitors, including fusion inhibitors and chemokine coreceptor (CCR) inhibitors; nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs); non-nucleoside reverse...

  • Clinical Management of Treatment- Experienced, HIV/AIDS Patients in the Combination Antiretroviral Therapy Era. Boyd, Mark A.; Hill, Andrew M. // PharmacoEconomics;2010 Supplement, Vol. 28, p17 

    Despite the success of combination antiretroviral therapy (ART) in improving clinical outcomes, treatment failure remains a significant challenge, particularly for highly treatment-experienced patients. This review evaluates current issues in the management of HIV-infected, treatment-experienced...

  • Factors affecting default among pre-ART patients in Eastern Uttar Pradesh. Kansal, Sangeeta; Sundar, Shyam; Rai, Madhukar; Tiwary, Narendra Kumar; Chakravarty, Jaya // BMC Infectious Diseases;2012 Supplement, Vol. 12 Issue Supplment 1, p1 

    The article presents a study on the factors affecting default among pre-antiretroviral therapy (ART) patients in Eastern Uttar Pradesh, India. The mentions that the rention of HIV patients in the is a challenge in preventing the development of the disease. They note that there is a significant...

  • Is antiretroviral therapy associated with symptom prevalence and burden? Harding, Richard; Molloy, Tim; Easterbrook, Philippa; Frame, Karen; Higginson, Irene J. // International Journal of STD & AIDS;Jun2006, Vol. 17 Issue 6, p400 

    Although distressing pain and other symptoms have been reported at all stages of HIV disease, studies have not taken account of the relative contribution of treatment side-effects and underlying disease. This study aimed to assess the prevalence of symptoms, their burden and the association with...

  • Cohort Profile: Standardized Management of Antiretroviral Therapy Cohort (MASTER Cohort). Torti, Carlo; Raffetti, Elena; Donato, Francesco; Castelli, Francesco; Maggiolo, Franco; Angarano, Gioacchino; Mazzotta, Francesco; Gori, Andrea; Sighinolfi, Laura; Pan, Angelo; Cauda, Roberto; Scalzini, Alfredo; Quiros-Roldan, Eugenia; Nasta, Paola; Gregis, Giampietro; Benatti, Simone; Digiambenedetto, Simona; Ladisa, Nicoletta; Giralda, Mariarosaria; Saracino, Annalisa // International Journal of Epidemiology;Apr2017, Vol. 46 Issue 2, p1 

    No abstract available.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics