Let's talk chronic disease: can differentiated service delivery address the syndemics of HIV, hypertension and diabetes?
Curr Opin HIV AIDS
; 15(4): 256-260, 2020 07.
Article
em En
| MEDLINE
| ID: mdl-32398467
ABSTRACT
PURPOSE OF REVIEW Differentiated service delivery (DSD) for HIV provides an approach to scaling services that are client-centred and aims to address client challenges whilst reducing the burden on health systems. With access to antiretroviral therapy, people living with HIV are living longer and increasingly present with comorbid conditions, such as hypertension and diabetes. This review presents the syndemic burden of HIV, hypertension and diabetes and highlights opportunities and challenges to leveraging DSD across diseases. RECENT FINDINGS:
Prevalence of hypertension and diabetes in the eight highest HIV prevalence countries ranges between 20-24% (31.9% in those >50 years old) and 4-10%, respectively. Service delivery models addressing the concurrent syndemics focus primarily on integration of services. Two DSD examples were found where people living with HIV and other comorbidities had their care and treatment supported in healthcare worker-led facility-based adherence clubs.SUMMARY:
Key enablers that have supported DSD for HIV such as simplified algorithms, optimized formulations, secure drug supply, and strengthened monitoring and evaluation systems are lacking for hypertension and diabetes and thus pose a major challenge to leveraging DSD models for people with syndemic conditions. However, the DSD approach may also catalyse opportunities to provide person-centred care for these syndemics and more implementation research in this area is warranted.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Diabetes Mellitus
/
Hipertensão
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Revista:
Curr Opin HIV AIDS
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Suíça