TY - JOUR
T1 - The shinyanga patient: A patient’s journey through hiv treatment cascade in rural Tanzania
AU - Okere, Nwanneka E.
AU - Sambu, Veryeh
AU - Ndungile, Yudas
AU - van Praag, Eric
AU - Hermans, Sabine
AU - Naniche, Denise
AU - Rinke de Wit, Tobias F.
AU - Maokola, Werner
AU - Gomez, Gabriela B.
N1 - Funding Information: Funding: N.E.O. was supported by the Erasmus Mundus Joint Doctorate Trans Global Health Programme (EMJD-TGH), Framework Partnership Agreement 2013-0039, Specific Grant Agreement 2015-1595, and the Amsterdam Institute for Global Health and Development (AIGHD). The funders had no role in the design, execution, interpretation, or writing of the study. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/8/2
Y1 - 2021/8/2
N2 - The 2016–2017 Tanzania HIV Impact Survey (THIS) reported the accomplishments towards the 90-90-90 global HIV targets at 61-94-87, affirming the need to focus on the first 90 (i.e., getting 90% of people living with HIV (PLHIV) tested). We conducted a patient-pathway analysis to understand the gap observed, by assessing the alignment between where PLHIV seek healthcare and where HIV services are available in the Shinyanga region, Tanzania. We used existing and pub-licly available data from the National AIDS Control program, national surveys, registries, and rele-vant national reports. Region-wide, the majority (n = 458/722, 64%) of THIS respondents accessed their last HIV test at public sector facilities. There were 65.9%, 45.1%, and 74.1% who could also access antiretroviral therapy (ART), CD4 testing, and HIV viral load testing at the location of their last HIV test, respectively. In 2019, the viral suppression rate estimated among PLHIV on ART in the Shinyanga region was 91.5%. PLHIV access HIV testing mostly in public health facilities; our research shows that synergies can be achieved to improve access to services further down the cascade in this sector. Furthermore, effective engagement with the private sector (not-for-profit and for-profit) will help to achieve the last mile toward ending the HIV epidemic.
AB - The 2016–2017 Tanzania HIV Impact Survey (THIS) reported the accomplishments towards the 90-90-90 global HIV targets at 61-94-87, affirming the need to focus on the first 90 (i.e., getting 90% of people living with HIV (PLHIV) tested). We conducted a patient-pathway analysis to understand the gap observed, by assessing the alignment between where PLHIV seek healthcare and where HIV services are available in the Shinyanga region, Tanzania. We used existing and pub-licly available data from the National AIDS Control program, national surveys, registries, and rele-vant national reports. Region-wide, the majority (n = 458/722, 64%) of THIS respondents accessed their last HIV test at public sector facilities. There were 65.9%, 45.1%, and 74.1% who could also access antiretroviral therapy (ART), CD4 testing, and HIV viral load testing at the location of their last HIV test, respectively. In 2019, the viral suppression rate estimated among PLHIV on ART in the Shinyanga region was 91.5%. PLHIV access HIV testing mostly in public health facilities; our research shows that synergies can be achieved to improve access to services further down the cascade in this sector. Furthermore, effective engagement with the private sector (not-for-profit and for-profit) will help to achieve the last mile toward ending the HIV epidemic.
KW - Access
KW - HIV
KW - Health services
KW - Patient-pathway analysis
KW - Sub-Saharan Africa
UR - http://www.scopus.com/inward/record.url?scp=85112488835&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/ijerph18168418
DO - https://doi.org/10.3390/ijerph18168418
M3 - Article
C2 - 34444166
SN - 1661-7827
VL - 18
JO - International journal of environmental research and public health
JF - International journal of environmental research and public health
IS - 16
M1 - 8418
ER -