2023-09-28 14:46:10 +00:00
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abstract: 'Background: The role of socio-cultural factors in influencing access to
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HIV/AIDS treatment, care and support is increasingly recognized by
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researchers, international donors and policy makers. Although many of
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them have been identified through qualitative studies, the evidence
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gathered by quantitative studies has not been systematically analysed.
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To fill this knowledge gap, we did a systematic review of quantitative
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studies comparing surveys done in high and low income countries to
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assess the extent to which socio-cultural determinants of access,
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identified through qualitative studies, have been addressed in
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epidemiological survey studies.
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Methods: Ten electronic databases were searched (Cinahl, EMBASE, ISI Web
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of Science, IBSS, JSTOR, MedLine, Psyinfo, Psyindex and Cochrane). Two
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independent reviewers selected eligible publications based on the
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inclusion/exclusion criteria. Meta-analysis was used to synthesize data
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comparing studies between low and high income countries.
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Results: Thirty-four studies were included in the final review, 21
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(62\%) done in high income countries and 13 (38\%) in low income
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countries. In low income settings, epidemiological research on access to
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HIV/AIDS services focused on socio-economic and health system factors
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while in high income countries the focus was on medical and psychosocial
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factors. These differences depict the perceived different barriers in
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the two regions. Common factors between the two regions were also found
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to affect HIV testing, including stigma, high risk sexual behaviours
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such as multiple sexual partners and not using condoms, and alcohol
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abuse. On the other hand, having experienced previous illness or other
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health conditions and good family communication was associated with
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adherence to ART uptake. Due to insufficient consistent data, a
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meta-analysis was only possible on adherence to treatment.
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Conclusions: This review offers evidence of the current challenges for
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interdisciplinary work in epidemiology and public health. Quantitative
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studies did not systematically address in their surveys important
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factors identified in qualitative studies as playing a critical role on
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the access to HIV/AIDS services. The evidences suggest that the problem
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lies in the exclusion of the qualitative information during the
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questionnaire design. With the changing face of the epidemic, we need a
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new and improved research strategy that integrates the results of
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qualitative studies into quantitative surveys.'
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affiliation: 'Merten, S (Corresponding Author), Swiss Trop \& Publ Hlth Inst, Dept
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Epidemiol \& Publ Hlth, Basel, Switzerland.
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Gari, Sara; Martin-Hilber, Adriane; Merten, Sonja, Swiss Trop \& Publ Hlth Inst,
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Dept Epidemiol \& Publ Hlth, Basel, Switzerland.
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Gari, Sara; Martin-Hilber, Adriane; Merten, Sonja, Univ Basel, Basel, Switzerland.
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Doig-Acuna, Camilo, CUNY, Sophie Davis Sch Biomed Educ, New York, NY 10021 USA.
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Smail, Tino, Particip GmBH, Freiburg, Germany.
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Malungo, Jacob R. S., Univ Zambia, Dept Populat Studies, Lusaka, Zambia.'
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article-number: '198'
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author: Gari, Sara and Doig-Acuna, Camilo and Smail, Tino and Malungo, Jacob R. S.
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and Martin-Hilber, Adriane and Merten, Sonja
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author-email: sonja.merten@unibas.ch
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author_list:
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- family: Gari
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given: Sara
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- family: Doig-Acuna
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given: Camilo
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- family: Smail
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given: Tino
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- family: Malungo
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given: Jacob R. S.
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- family: Martin-Hilber
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given: Adriane
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- family: Merten
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given: Sonja
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da: '2023-09-28'
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doi: 10.1186/1472-6963-13-198
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eissn: 1472-6963
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files: []
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journal: BMC HEALTH SERVICES RESEARCH
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keywords: 'Socio-cultural barriers; Access; Adherence; HIV/AIDS; Antiretroviral
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therapy; Survey study; Systematic review'
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keywords-plus: 'ANTIRETROVIRAL THERAPY ADHERENCE; PATIENT-REPORTED BARRIERS; SUB-SAHARAN
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AFRICA; MEDICATION ADHERENCE; HIV PATIENTS; HAART; NONADHERENCE;
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DEPRESSION; FAILURE; STIGMA'
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language: English
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month: MAY 28
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number-of-cited-references: '45'
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orcid-numbers: Merten, Sonja/0000-0003-4115-106X
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papis_id: 190b3833072a2660f4e98b3e9cdae440
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ref: Gari2013accesshivaids
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tags:
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- review
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times-cited: '62'
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title: 'Access to HIV/AIDS care: a systematic review of socio-cultural determinants
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in low and high income countries'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000320050100001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '32'
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volume: '13'
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web-of-science-categories: Health Care Sciences \& Services
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year: '2013'
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