Melissa Doutre, Marie-Pier Godin, Iliya Dmitriev, Ana Paula Pena-Gralle, Amy Bergeron, Lucie Blais, Benoît Lemire
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引用次数: 0
Abstract
Background/objectives: Access to antiretroviral (ARV) drugs remains a critical challenge in achieving the WHO/UNAIDS 95-95-95 targets, with medication costs representing a substantial barrier. This systematic review evaluates the effect of free ARVs, without out-of-pocket cost to the patient, on the HIV cascade of care: the use of ARV therapy, viral suppression and the use of prophylaxis (PrEP).
Methods: The following databases were searched for publications between 1 January 1996 and 10 July 2024: MEDLINE, Embase, CINAHL, CNKI, Global Index Medicus, the Web of Science, the SciELO Citation Index and grey literature. Publications were eligible if they included people living with or at risk of HIV and compared free access to ARVs with out-of-pocket fees. Reviewers screened publications that focused on the outcomes: being on therapy, being virally suppressed and being on PrEP. The National Heart, Lung and Blood Institute (NHLBI) and Joanna Briggs Institute (JBI) Quality Assessment Tools were used to assess publication quality.
Results: A total of 34164 documents were identified, and 407 full-text manuscripts were reviewed. A total of 22 publications met the inclusion criteria. In six of the seven publications reporting on being on therapy, providing free ARVs increased the number of people who received treatment. All four publications reporting on viral suppression showed improvement with free access. Additionally, both publications reporting on PrEP use showed increased utilization with free access.
Conclusions: The review offers valuable insights for countries considering implementing free ARV programmes. It suggests that expanding access to free ARVs helps achieve the global HIV targets and improve health outcomes.
背景/目标：获得抗逆转录病毒药物仍然是实现世卫组织/联合国艾滋病规划署95-95-95目标的一个重大挑战，药物费用是一个重大障碍。本系统综述评估了免费抗逆转录病毒药物（无需患者自付费用）对艾滋病毒级联护理的影响：使用抗逆转录病毒药物治疗、病毒抑制和使用预防（PrEP）。方法：检索1996年1月1日至2024年7月10日发表的文献：MEDLINE、Embase、CINAHL、CNKI、Global Index Medicus、Web of Science、SciELO引文索引和灰色文献。如果出版物包括艾滋病毒感染者或有风险的人，并将免费获得抗逆转录病毒药物与自付费用进行比较，则符合条件。审稿人筛选了关注结果的出版物：接受治疗、病毒抑制和PrEP。使用国家心肺血液研究所（NHLBI）和乔安娜布里格斯研究所（JBI）质量评估工具评估出版物质量。结果：共检索到34164篇文献，审阅到407篇全文稿件。共有22篇出版物符合纳入标准。在报告正在接受治疗的7份出版物中，有6份提供免费抗逆转录病毒药物增加了接受治疗的人数。所有四份报告病毒抑制的出版物都显示了免费获取的改善。此外，两份报告PrEP使用情况的出版物均显示免费获取的使用率有所增加。结论：该审查为考虑实施免费抗逆转录病毒药物规划的国家提供了宝贵的见解。报告表明，扩大获得免费抗逆转录病毒药物的机会有助于实现全球艾滋病毒目标并改善健康结果。
期刊介绍：
HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
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