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Community and service provider views to inform the 2013 WHO consolidated antiretroviral guidelines: key findings and lessons learnt

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Community and service provider views to inform the 2013 WHO consolidated antiretroviral guidelines: key findings and lessons learnt. / Hsieh, Amy; Mburu, Gitau; Garner, Adam et al.
In: AIDS, Vol. 28, No. Suupl. 2, 03.2014, p. S205-216.

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Harvard

Hsieh, A, Mburu, G, Garner, A, Teltschik, A, Ram, M, Mallouris, C, Penazzato, M, Shaffer, N, Easterbrook, P & Ball, A 2014, 'Community and service provider views to inform the 2013 WHO consolidated antiretroviral guidelines: key findings and lessons learnt', AIDS, vol. 28, no. Suupl. 2, pp. S205-216. https://doi.org/10.1097/QAD.0000000000000251

APA

Hsieh, A., Mburu, G., Garner, A., Teltschik, A., Ram, M., Mallouris, C., Penazzato, M., Shaffer, N., Easterbrook, P., & Ball, A. (2014). Community and service provider views to inform the 2013 WHO consolidated antiretroviral guidelines: key findings and lessons learnt. AIDS, 28(Suupl. 2), S205-216. https://doi.org/10.1097/QAD.0000000000000251

Vancouver

Hsieh A, Mburu G, Garner A, Teltschik A, Ram M, Mallouris C et al. Community and service provider views to inform the 2013 WHO consolidated antiretroviral guidelines: key findings and lessons learnt. AIDS. 2014 Mar;28(Suupl. 2):S205-216. doi: 10.1097/QAD.0000000000000251

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Bibtex

@article{e2b204d753a4469ca9fceeb60b91cf2c,
title = "Community and service provider views to inform the 2013 WHO consolidated antiretroviral guidelines: key findings and lessons learnt",
abstract = "Objective:The objective was to evaluate community and healthcare worker (HCW) values and preferences on key topics to inform the development of the 2013 WHO consolidated guidelines for antiretroviral therapy in low and middle income countries.Design:Cross-sectional e-survey and e-forum discussion; focus group discussions (FGDs)Methods:Data were collected on community perspectives regarding a range of potential clinical and operational recommendations in the 2013 guidelines between November 2012 and January 2013 through an e-survey (n = 1088) and e-forum (n = 955). Additional FGDs were held with people living with HIV (PLHIV) in Malawi and Uganda (n = 88) on antiretroviral therapy (ART) use among pregnant women. Two surveys were also undertaken on similar topics covered in the e-survey for health care workers caring for adults (n = 98) and children (n = 348).Results:There were 1088 e-survey respondents from 117 countries: of whom 37.7% (298/791) were females, 49.9% (431/864) PLHIV, and 20.9% (174/831) from low-income countries. The proportion of e-survey respondents who supported raising the CD4 T-cell threshold for ART initiation in adults from 350 to 500 cells/μl was 51.0% (355/696), and regardless of CD4 T-cell count for all pregnant females 89.8% (607/676), HIV serodiscordant partners 71.9% (486/676), and all children on diagnosis of infection 47.4% (212/447). E-survey respondents strongly supported discontinuing use of stavudine (72.7%, 416/572), task-shifting/sharing from doctors to nurses (75.2%, 275/365) and from nurses to community health workers (71.1%, 261/367) as strategies to expand access to HIV testing, care, and treatment. Focus group discussion respondents identified service capacity, and social and legal concerns as key considerations influencing the decisions of women living with HIV to continue ART after the risk of vertical transmission has passed. Key lessons learnt in these consultations included the need for piloting and validation of questions; sufficient time to adequately disseminate the survey; and consideration of using FGDs and mobile phone technology to improve participation of people with limited internet access.Conclusion:Community participation in guideline development processes is important to ensure that their perspectives are considered in the resulting recommendations. Communities should be actively involved in the adaptation, implementation, and accountability processes related to the guidelines.",
keywords = "HIV, treatment, guidelines",
author = "Amy Hsieh and Gitau Mburu and Adam Garner and Anja Teltschik and Mala Ram and Chris Mallouris and Maria Penazzato and Nathan Shaffer and Phillippa Easterbrook and Andrew Ball",
note = "This article is distributed under the terms of the Creative Commons Attribution -Noncommercial-No Derivative License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.",
year = "2014",
month = mar,
doi = "10.1097/QAD.0000000000000251",
language = "English",
volume = "28",
pages = "S205--216",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "Suupl. 2",

}

RIS

TY - JOUR

T1 - Community and service provider views to inform the 2013 WHO consolidated antiretroviral guidelines

T2 - key findings and lessons learnt

AU - Hsieh, Amy

AU - Mburu, Gitau

AU - Garner, Adam

AU - Teltschik, Anja

AU - Ram, Mala

AU - Mallouris, Chris

AU - Penazzato, Maria

AU - Shaffer, Nathan

AU - Easterbrook, Phillippa

AU - Ball, Andrew

N1 - This article is distributed under the terms of the Creative Commons Attribution -Noncommercial-No Derivative License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

PY - 2014/3

Y1 - 2014/3

N2 - Objective:The objective was to evaluate community and healthcare worker (HCW) values and preferences on key topics to inform the development of the 2013 WHO consolidated guidelines for antiretroviral therapy in low and middle income countries.Design:Cross-sectional e-survey and e-forum discussion; focus group discussions (FGDs)Methods:Data were collected on community perspectives regarding a range of potential clinical and operational recommendations in the 2013 guidelines between November 2012 and January 2013 through an e-survey (n = 1088) and e-forum (n = 955). Additional FGDs were held with people living with HIV (PLHIV) in Malawi and Uganda (n = 88) on antiretroviral therapy (ART) use among pregnant women. Two surveys were also undertaken on similar topics covered in the e-survey for health care workers caring for adults (n = 98) and children (n = 348).Results:There were 1088 e-survey respondents from 117 countries: of whom 37.7% (298/791) were females, 49.9% (431/864) PLHIV, and 20.9% (174/831) from low-income countries. The proportion of e-survey respondents who supported raising the CD4 T-cell threshold for ART initiation in adults from 350 to 500 cells/μl was 51.0% (355/696), and regardless of CD4 T-cell count for all pregnant females 89.8% (607/676), HIV serodiscordant partners 71.9% (486/676), and all children on diagnosis of infection 47.4% (212/447). E-survey respondents strongly supported discontinuing use of stavudine (72.7%, 416/572), task-shifting/sharing from doctors to nurses (75.2%, 275/365) and from nurses to community health workers (71.1%, 261/367) as strategies to expand access to HIV testing, care, and treatment. Focus group discussion respondents identified service capacity, and social and legal concerns as key considerations influencing the decisions of women living with HIV to continue ART after the risk of vertical transmission has passed. Key lessons learnt in these consultations included the need for piloting and validation of questions; sufficient time to adequately disseminate the survey; and consideration of using FGDs and mobile phone technology to improve participation of people with limited internet access.Conclusion:Community participation in guideline development processes is important to ensure that their perspectives are considered in the resulting recommendations. Communities should be actively involved in the adaptation, implementation, and accountability processes related to the guidelines.

AB - Objective:The objective was to evaluate community and healthcare worker (HCW) values and preferences on key topics to inform the development of the 2013 WHO consolidated guidelines for antiretroviral therapy in low and middle income countries.Design:Cross-sectional e-survey and e-forum discussion; focus group discussions (FGDs)Methods:Data were collected on community perspectives regarding a range of potential clinical and operational recommendations in the 2013 guidelines between November 2012 and January 2013 through an e-survey (n = 1088) and e-forum (n = 955). Additional FGDs were held with people living with HIV (PLHIV) in Malawi and Uganda (n = 88) on antiretroviral therapy (ART) use among pregnant women. Two surveys were also undertaken on similar topics covered in the e-survey for health care workers caring for adults (n = 98) and children (n = 348).Results:There were 1088 e-survey respondents from 117 countries: of whom 37.7% (298/791) were females, 49.9% (431/864) PLHIV, and 20.9% (174/831) from low-income countries. The proportion of e-survey respondents who supported raising the CD4 T-cell threshold for ART initiation in adults from 350 to 500 cells/μl was 51.0% (355/696), and regardless of CD4 T-cell count for all pregnant females 89.8% (607/676), HIV serodiscordant partners 71.9% (486/676), and all children on diagnosis of infection 47.4% (212/447). E-survey respondents strongly supported discontinuing use of stavudine (72.7%, 416/572), task-shifting/sharing from doctors to nurses (75.2%, 275/365) and from nurses to community health workers (71.1%, 261/367) as strategies to expand access to HIV testing, care, and treatment. Focus group discussion respondents identified service capacity, and social and legal concerns as key considerations influencing the decisions of women living with HIV to continue ART after the risk of vertical transmission has passed. Key lessons learnt in these consultations included the need for piloting and validation of questions; sufficient time to adequately disseminate the survey; and consideration of using FGDs and mobile phone technology to improve participation of people with limited internet access.Conclusion:Community participation in guideline development processes is important to ensure that their perspectives are considered in the resulting recommendations. Communities should be actively involved in the adaptation, implementation, and accountability processes related to the guidelines.

KW - HIV

KW - treatment

KW - guidelines

U2 - 10.1097/QAD.0000000000000251

DO - 10.1097/QAD.0000000000000251

M3 - Journal article

VL - 28

SP - S205-216

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - Suupl. 2

ER -