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Showing 1 - 3 of 3 Results for "Rwanda"

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Provision and Access Gap
Additional outreach programs are needed for patients who miss ART clinic visits or fail to initiate treatment. A study showed that issues such as provider to patient ratios; adherence support programs; and needing transport from rural areas were associated with lower CD4 counts at initiation of ART. Other studies showed that patients were lost between initiation and maintenance sites. Another study found that one in five treatment-eligible HIV-positive individuals refused to initiate ART (Katz et al., 2011). Others who dropped out of treatment were using unproven remedies.
Provision and Access
1 study
Scale up of testing is needed with competent staff and labs in order to assess CD4 counts and link those who test HIV-positive to treatment. Studies are finding that in some countries, those who test HIV-positive are presenting with AIDS and that patients do not initiate ART despite eligibility. Those who test HIV-positive yet not eligible to receive antiretroviral therapy according to their national guidelines often did not remain in care until they were eligible for treatment.
Provision and Access
1 study
Initiatives that provide for early diagnosis and appropriate longitudinal care prior to treatment eligibility are needed to reduce mortality rates and costs among adults accessing treatment. A review found that early mortality among adults accessing antiretroviral therapy can be attributed to late diagnosis of HIV. Despite multiple interactions with parts of the healthcare system, a study of women in Uganda found that late presentation for HIV care resulted largely from the, “inability of the medical system to link women to appropriate care,” (McGrath et al., 2012: 1095). Women entered care only when symptomatic. Another study found that more than a quarter of HIV patients in care prior to ART initiation did not start ART according to national guideline criteria. Another study found that women did not know where to go to access treatment. A review found that a process is needed to optimize transfers of care without treatment interruption and with appropriate medical documentation. Another study found that over half of patients who were not yet known to be eligible for ART at enrollment but who had tested HIV-positive, including a quarter who had CD4 counts taken, were lost to follow up. Another review found that asymptomatic patients perceived little need to initiate ART. Another study found that those with higher CD4 counts who were not yet eligible for ART lacked social support and social capital, yet needed this support.
Provision and Access
1 study