Healthcare delivery for HIV-positive people with tuberculosis in Europe.
HIV Med
; 22(4): 283-293, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-33215809
ABSTRACT
BACKGROUND:
In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE).OBJECTIVES:
To verify the differences in TB and HIV services in EE vs. WE.METHODS:
Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey.RESULTS:
Delivery of healthcare was significantly less integrated in EE provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged.CONCLUSION:
Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Tuberculose
/
Infecções por HIV
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article