Research priorities to inform "Treat All" policy implementation for people living with HIV in sub-Saharan Africa: a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA).
90-90-90 targets
Treat All
implementation science
sub-Saharan Africa
universal HIV treatment
Journal
Journal of the International AIDS Society
ISSN: 1758-2652
Titre abrégé: J Int AIDS Soc
Pays: Switzerland
ID NLM: 101478566
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
03
07
2018
accepted:
07
11
2018
entrez:
19
1
2019
pubmed:
19
1
2019
medline:
15
2
2020
Statut:
ppublish
Résumé
"Treat All" - the treatment of all people with HIV, irrespective of disease stage or CD4 cell count - represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation. The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa. The process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders - groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations. Reflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.
Identifiants
pubmed: 30657644
doi: 10.1002/jia2.25218
pmc: PMC6338103
doi:
Types de publication
Consensus Development Conference
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25218Subventions
Organisme : NIMH NIH HHS
ID : P30 MH062246
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI096299
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH019105
Pays : United States
Organisme : NIMH NIH HHS
ID : P30 MH043520
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD087993
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069911
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069919
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI124414
Pays : United States
Organisme : NIAID NIH HHS
ID : R13 AI134393
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD050924
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069924
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Investigateurs
Keri Althoff
(K)
Craig R Cohen
(CR)
Geraldina Dominguez
(G)
Stephany N Duda
(SN)
Aimee Freeman
(A)
Antoine Jaquet
(A)
April D Kimmel
(AD)
Kathryn E Lancaster
(KE)
Janne Markus
(J)
Rosemary McKaig
(R)
Pamela M Murnane
(PM)
Dominique Nsonde
(D)
Angela M Parcesepe
(AM)
Per M von Groote
(PM)
Rachel C Vreeman
(RC)
Carolyn F Williams
(CF)
Constantin Yiannoutsos
(C)
Informations de copyright
© 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.
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