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AIDS and Behavior
Erschienen in: AIDS and Behavior 7/2014

01.07.2014 | Substantive Review

Impact of Geographic and Transportation-Related Barriers on HIV Outcomes in Sub-Saharan Africa: A Systematic Review

verfasst von: Alexander J. Lankowski, Mark J. Siedner, David R. Bangsberg, Alexander C. Tsai

Erschienen in: AIDS and Behavior | Ausgabe 7/2014

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Abstract

Difficulty obtaining reliable transportation to clinic is frequently cited as a barrier to HIV care in sub-Saharan Africa (SSA). Numerous studies have sought to characterize the impact of geographic and transportation-related barriers on HIV outcomes in SSA, but to date there has been no systematic attempt to summarize these findings. In this systematic review, we summarized this body of literature. We searched for studies conducted in SSA examining the following outcomes in the HIV care continuum: (1) voluntary counseling and testing, (2) pre-antiretroviral therapy (ART) linkage to care, (3) loss to follow-up and mortality, and (4) ART adherence and/or viral suppression. We identified 34 studies containing 52 unique estimates of association between a geographic or transportation-related barrier and an HIV outcome. There was an inverse effect in 23 estimates (44 %), a null association in 26 (50 %), and a paradoxical beneficial impact in 3 (6 %). We conclude that geographic and transportation-related barriers are associated with poor outcomes across the continuum of HIV care.
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Metadaten
Titel
Impact of Geographic and Transportation-Related Barriers on HIV Outcomes in Sub-Saharan Africa: A Systematic Review
verfasst von
Alexander J. Lankowski
Mark J. Siedner
David R. Bangsberg
Alexander C. Tsai
Publikationsdatum
01.07.2014
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 7/2014
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-014-0729-8

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