The HIV care and treatment cascade of adolescents and young adults living with HIV in sub-Saharan Africa: a systematic review and meta-analysis protocol.
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Abstract
Background: The Joint United Nations Programme on HIV/AIDS called for the end of the HIV pandemic by 2030 by setting the 95-95-95 HIV cascade targets. This cascade is used to monitor the progress of different populations in different settings. The progress of adolescents and young adults (AYA) living with HIV in sub-Saharan Africa (SSA) toward these targets remains unknown. We propose to conduct a systematic review and meta-analysis to assess the proportion of AYA retained at each step of the HIV care cascade in SSA.
Method: Studies published between 2015 to date that reported on the HIV care cascade among AYA in SSA will be included. The following databases will be searched: PubMed/MEDLINE, Embase, Scopus, CINAHL, African Index Medicus (AIM), African Journals Online (AJOL), SABINET African Journals, HINARI (for institutional access to global journals) and University institutional repositories and gray literature sources will be searched. Two reviewers will independently screen titles and abstracts, assess the full texts for eligibility, and extract data. Disagreements will be resolved by consensus and consultation with a third reviewer. The number and proportion of AYA retained in the HIV care cascade from HIV diagnosis, initiation of ART, and viral suppression will be used for the meta-analysis. Random-effect statistical models will be used to estimate the pooled proportion of AYA retained at each step of the cascade. The results will be graphically represented via forest plots. Variability across studies will be assessed via heterogeneity test statistics (I2).
Discussion: This systematic review aims to synthesize current evidence and identify gaps in the treatment cascade. The findings of this meta-analysis provide guidance for designing a framework to improve the care and treatment of AYA living with HIV.
Systematic review registration: PROSPERO registration number CRD42024561024.
背景：联合国艾滋病毒/艾滋病联合规划署呼吁到2030年结束艾滋病毒流行病，为此制定了95-95-95艾滋病毒级联目标。这个级联用于监测不同环境下不同种群的进展。撒哈拉以南非洲（SSA）感染艾滋病毒的青少年和青壮年（AYA）在实现这些目标方面的进展尚不清楚。我们建议进行一项系统回顾和荟萃分析，以评估在SSA的HIV护理级联的每个步骤中保留的AYA比例。方法：将纳入2015年至今发表的关于SSA AYA中HIV护理级联的研究。将检索以下数据库：PubMed/MEDLINE、Embase、Scopus、CINAHL、African Index Medicus （AIM）、African Journals Online （AJOL）、SABINET African Journals、HINARI（用于机构访问全球期刊）和大学机构知识库和灰色文献来源。两名审稿人将独立筛选标题和摘要，评估全文的合格性，并提取数据。分歧将通过协商一致和与第三审稿人协商解决。从HIV诊断、开始抗逆转录病毒治疗到病毒抑制的HIV护理级联中保留的AYA的数量和比例将用于荟萃分析。随机效应统计模型将用于估计在级联的每一步保留的AYA的合并比例。结果将通过森林图以图形方式表示。研究间的可变性将通过异质性检验统计来评估（I2）。讨论：本系统综述旨在综合现有证据并确定治疗级联中的差距。这项荟萃分析的结果为设计一个框架来改善艾滋病毒感染者的护理和治疗提供了指导。系统评审注册：PROSPERO注册号CRD42024561024。
期刊介绍：
Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.
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