TY - JOUR
T1 - Future directions for HIV service delivery research
T2 - Research gaps identified through WHO guideline development process
AU - Ford, Nathan
AU - Eshun-Wilson, Ingrid
AU - Ameyan, Wole
AU - Newman, Morkor
AU - Vojnov, Lara
AU - Doherty, Meg
AU - Geng, Elvin
N1 - Funding Information:
This work was supported by a grant from the Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2021 Ford et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/9
Y1 - 2021/9
N2 - • Improvements in HIV service delivery are key to bringing countries closer to achieving the target of ending AIDS as a public health threat and situating HIV treatment and care as part of universal healthcare coverage. • The World Health Organization (WHO) guideline development process is recognized as one approach to identifying research gaps. Systematic reviews form the basis of recommendations formulated by an expert guideline development group, which is also tasked to identify research gaps. • The 2021 WHO HIV Service Delivery Guideline process identified 27 research gaps grouped into 8 areas where more research is needed to support enhancement and implementation of the new recommendations across the cascade of care. • Areas covered by WHO Service Delivery Guideline include antiretroviral therapy (ART) initiation outside the health facility, frequency of visits/refills, tracing and reengagement in care, assessing adherence, integration of HIV and sexual and reproductive health services, integration of HIV and diabetes and hypertension care, psychosocial interventions for adolescents, and task sharing of specimen collection and point-ofcare testing. • Key areas identified by the guideline process that could benefit from future research include tools to support ART initiation outside the health facility, outcomes of spacing of clinical visits/drug refills beyond 6 months, tailored support to minimize disengagement and support reengagement along the continuum of care, and accurate, feasible measures of adherence. • Strategies of integration of HIV and sexual and reproductive health services and hypertension and diabetes care, costs and cost-effectiveness of psychological support interventions, the performance of newer point-of-care technologies by nonlaboratory personnel, and the impact of diagnostic integration across disease types were also identified as key areas that would benefit from future research.
AB - • Improvements in HIV service delivery are key to bringing countries closer to achieving the target of ending AIDS as a public health threat and situating HIV treatment and care as part of universal healthcare coverage. • The World Health Organization (WHO) guideline development process is recognized as one approach to identifying research gaps. Systematic reviews form the basis of recommendations formulated by an expert guideline development group, which is also tasked to identify research gaps. • The 2021 WHO HIV Service Delivery Guideline process identified 27 research gaps grouped into 8 areas where more research is needed to support enhancement and implementation of the new recommendations across the cascade of care. • Areas covered by WHO Service Delivery Guideline include antiretroviral therapy (ART) initiation outside the health facility, frequency of visits/refills, tracing and reengagement in care, assessing adherence, integration of HIV and sexual and reproductive health services, integration of HIV and diabetes and hypertension care, psychosocial interventions for adolescents, and task sharing of specimen collection and point-ofcare testing. • Key areas identified by the guideline process that could benefit from future research include tools to support ART initiation outside the health facility, outcomes of spacing of clinical visits/drug refills beyond 6 months, tailored support to minimize disengagement and support reengagement along the continuum of care, and accurate, feasible measures of adherence. • Strategies of integration of HIV and sexual and reproductive health services and hypertension and diabetes care, costs and cost-effectiveness of psychological support interventions, the performance of newer point-of-care technologies by nonlaboratory personnel, and the impact of diagnostic integration across disease types were also identified as key areas that would benefit from future research.
UR - http://www.scopus.com/inward/record.url?scp=85115998581&partnerID=8YFLogxK
U2 - 10.1371/journal.pmed.1003812
DO - 10.1371/journal.pmed.1003812
M3 - Review article
C2 - 34555010
AN - SCOPUS:85115998581
SN - 1549-1277
VL - 18
JO - PLoS medicine
JF - PLoS medicine
IS - 9
M1 - e1003812
ER -