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Effects of community-based antiretroviral therapy initiation models on HIV treatment outcomes: A systematic review and meta-analysis

PLoS Medicine Jun 04, 2021

Eshun-Wilson I, Awotiwon A, Germann A, et al. - Via performing a systematic review and meta-analysis, researchers sought to ascertain the effect of offering antiretroviral therapy (ART) initiation at community locations, including homes, mobile vans, or other community venues, on HIV treatment outcomes. Among eight identified studies (including 11,196 HIV-positive people), seven were performed in sub-Saharan Africa; 4 were randomized controlled trials and 4 were cohort studies. Meta-analysis of this limited dataset suggests higher ART uptake, higher retention, and greater viral suppression at 1 year in correlation with ART initiation in the community compared with facility-based ART initiation and refill, among HIV-positive people offered ART. These findings remained consistent across population subgroups and numerous implementation strategies. Insufficient data were there regarding serious adverse events or mortality to draw robust conclusions on these outcomes.

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