Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature
The uptake of antiretroviral therapy (ART) is critical to meeting the global HIV treatment goal of 95-95-95 by 2025. Although a few Sub-Saharan African countries have already achieved this target, the prevalence of bypassing primary ART centres in many countries in the subregion has negative implica...
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Elsevier
2024-12-01
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| Series: | Journal of Virus Eradication |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S205566402400195X |
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| author | Maximillian Kolbe Domapielle Sadat Zakari Abugbila Marshall Kala |
| author_facet | Maximillian Kolbe Domapielle Sadat Zakari Abugbila Marshall Kala |
| author_sort | Maximillian Kolbe Domapielle |
| collection | DOAJ |
| description | The uptake of antiretroviral therapy (ART) is critical to meeting the global HIV treatment goal of 95-95-95 by 2025. Although a few Sub-Saharan African countries have already achieved this target, the prevalence of bypassing primary ART centres in many countries in the subregion has negative implications for ART uptake and use. This study used the access to health services framework to analyse the evidence and factors contributing to bypassing primary ART centres by individuals in the sub-region seeking HIV care and support. We found compelling evidence of the prevalence of ART clients bypassing their primary ART centres in search of specialised care in higher-tiered health facilities. Others use bypassing to conceal their HIV-positive status to avoid social stigma. We argue that introducing specialised and differentiated ART at the primary level of care can address this phenomenon. While we anticipate that this measure will satisfy clients' desire for specialised care, we recommend enhancing public awareness about the effectiveness of ART to reduce stigma towards ART clients. Legislation and strict enforcement of anti-HIV stigma laws, which outlaw and criminalise stigmatising people living with HIV (PLHIV), could potentially be an effective stigma-deterring measure. To complement this effort, PLHIV should be empowered to understand legislative instruments and steps to take when confidentiality and discriminatory issues arise. We recommend further research in Sub-Saharan Africa to investigate the relationship between bypassing primary ART centres and client adherence. The findings will help design appropriate strategies to increase ART uptake at primary ART centres. |
| format | Article |
| id | doaj-art-acc80c91d3a44c9f94fa1b894e0027cd |
| institution | Kabale University |
| issn | 2055-6640 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Virus Eradication |
| spelling | doaj-art-acc80c91d3a44c9f94fa1b894e0027cd2025-01-27T04:21:51ZengElsevierJournal of Virus Eradication2055-66402024-12-01104100580Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literatureMaximillian Kolbe Domapielle0Sadat Zakari Abugbila1Marshall Kala2Department of Governance and Development Management, Faculty of Public Policy, and Governance, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, U.W.R, Ghana; Corresponding author.Department of Governance and Development Management, Faculty of Public Policy, and Governance, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, U.W.R, GhanaUniversity of Ghana Learning Centre-Wa, School of Continuing and Distance Education, University of Ghana, Legon, GhanaThe uptake of antiretroviral therapy (ART) is critical to meeting the global HIV treatment goal of 95-95-95 by 2025. Although a few Sub-Saharan African countries have already achieved this target, the prevalence of bypassing primary ART centres in many countries in the subregion has negative implications for ART uptake and use. This study used the access to health services framework to analyse the evidence and factors contributing to bypassing primary ART centres by individuals in the sub-region seeking HIV care and support. We found compelling evidence of the prevalence of ART clients bypassing their primary ART centres in search of specialised care in higher-tiered health facilities. Others use bypassing to conceal their HIV-positive status to avoid social stigma. We argue that introducing specialised and differentiated ART at the primary level of care can address this phenomenon. While we anticipate that this measure will satisfy clients' desire for specialised care, we recommend enhancing public awareness about the effectiveness of ART to reduce stigma towards ART clients. Legislation and strict enforcement of anti-HIV stigma laws, which outlaw and criminalise stigmatising people living with HIV (PLHIV), could potentially be an effective stigma-deterring measure. To complement this effort, PLHIV should be empowered to understand legislative instruments and steps to take when confidentiality and discriminatory issues arise. We recommend further research in Sub-Saharan Africa to investigate the relationship between bypassing primary ART centres and client adherence. The findings will help design appropriate strategies to increase ART uptake at primary ART centres.http://www.sciencedirect.com/science/article/pii/S205566402400195XAntiretroviral therapyBypassingHIVPLHIVSub-saharan africa |
| spellingShingle | Maximillian Kolbe Domapielle Sadat Zakari Abugbila Marshall Kala Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature Journal of Virus Eradication Antiretroviral therapy Bypassing HIV PLHIV Sub-saharan africa |
| title | Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature |
| title_full | Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature |
| title_fullStr | Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature |
| title_full_unstemmed | Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature |
| title_short | Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature |
| title_sort | bypassing primary antiretroviral therapy centres in sub saharan africa an integrative review of the theoretical and empirical literature |
| topic | Antiretroviral therapy Bypassing HIV PLHIV Sub-saharan africa |
| url | http://www.sciencedirect.com/science/article/pii/S205566402400195X |
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