Cargando…

Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review

Adherence to HIV antiretroviral therapy (ART) is a crucial factor in health outcomes for people living with HIV (PLWH). Interventions to support ART adherence are increasingly focused on the household as a source of social support. This review aims to examine the social and structural determinants o...

Descripción completa

Detalles Bibliográficos
Autores principales: Campbell, Linda, Masquillier, Caroline, Thunnissen, Estrelle, Ariyo, Esther, Tabana, Hanani, Sematlane, Neo, Delport, Anton, Dube, Lorraine Tanyaradzwa, Knight, Lucia, Kasztan Flechner, Tair, Wouters, Edwin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312869/
https://www.ncbi.nlm.nih.gov/pubmed/32471153
http://dx.doi.org/10.3390/ijerph17113808
_version_ 1783549826139422720
author Campbell, Linda
Masquillier, Caroline
Thunnissen, Estrelle
Ariyo, Esther
Tabana, Hanani
Sematlane, Neo
Delport, Anton
Dube, Lorraine Tanyaradzwa
Knight, Lucia
Kasztan Flechner, Tair
Wouters, Edwin
author_facet Campbell, Linda
Masquillier, Caroline
Thunnissen, Estrelle
Ariyo, Esther
Tabana, Hanani
Sematlane, Neo
Delport, Anton
Dube, Lorraine Tanyaradzwa
Knight, Lucia
Kasztan Flechner, Tair
Wouters, Edwin
author_sort Campbell, Linda
collection PubMed
description Adherence to HIV antiretroviral therapy (ART) is a crucial factor in health outcomes for people living with HIV (PLWH). Interventions to support ART adherence are increasingly focused on the household as a source of social support. This review aims to examine the social and structural determinants of support for ART adherence within households and families in low- and middle-income countries (LMICs). The review methodology followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Seven databases were searched for peer-reviewed literature. The terms searched thematically covered (1) ART adherence, (2) household and family and (3) support and care. Thirty-three studies conducted in 15 LMICs were selected and a mixed methods synthesis was undertaken. Social and structural determinants affected the type, quality and amount of support for PLWH of all ages, which affected PLWH’s ART adherence. Gender norms affected the type of support that household members give to PLWH. Education moderated household support for ART adherence through literacy and language skills. Cultural context, religious beliefs, and social norms reinforced or undermined household support for ART adherence. Stigma affected disclosure, generated secrecy around giving medication and impeded access to support from the community. Supporting PLWH exacerbated economic hardship for household members. Health system dysfunction negatively impacted trust and communication between household members and health professionals. Intersecting social and structural determinants particularly affected the care given by household members who were older, female, with little education and low socioeconomic status. Household members were able to overcome some of these barriers when they received support themselves. Household interventions to support PLWH’s ART adherence should take structural factors into account to have maximum impact.
format Online
Article
Text
id pubmed-7312869
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-73128692020-06-29 Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review Campbell, Linda Masquillier, Caroline Thunnissen, Estrelle Ariyo, Esther Tabana, Hanani Sematlane, Neo Delport, Anton Dube, Lorraine Tanyaradzwa Knight, Lucia Kasztan Flechner, Tair Wouters, Edwin Int J Environ Res Public Health Review Adherence to HIV antiretroviral therapy (ART) is a crucial factor in health outcomes for people living with HIV (PLWH). Interventions to support ART adherence are increasingly focused on the household as a source of social support. This review aims to examine the social and structural determinants of support for ART adherence within households and families in low- and middle-income countries (LMICs). The review methodology followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Seven databases were searched for peer-reviewed literature. The terms searched thematically covered (1) ART adherence, (2) household and family and (3) support and care. Thirty-three studies conducted in 15 LMICs were selected and a mixed methods synthesis was undertaken. Social and structural determinants affected the type, quality and amount of support for PLWH of all ages, which affected PLWH’s ART adherence. Gender norms affected the type of support that household members give to PLWH. Education moderated household support for ART adherence through literacy and language skills. Cultural context, religious beliefs, and social norms reinforced or undermined household support for ART adherence. Stigma affected disclosure, generated secrecy around giving medication and impeded access to support from the community. Supporting PLWH exacerbated economic hardship for household members. Health system dysfunction negatively impacted trust and communication between household members and health professionals. Intersecting social and structural determinants particularly affected the care given by household members who were older, female, with little education and low socioeconomic status. Household members were able to overcome some of these barriers when they received support themselves. Household interventions to support PLWH’s ART adherence should take structural factors into account to have maximum impact. MDPI 2020-05-27 2020-06 /pmc/articles/PMC7312869/ /pubmed/32471153 http://dx.doi.org/10.3390/ijerph17113808 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Campbell, Linda
Masquillier, Caroline
Thunnissen, Estrelle
Ariyo, Esther
Tabana, Hanani
Sematlane, Neo
Delport, Anton
Dube, Lorraine Tanyaradzwa
Knight, Lucia
Kasztan Flechner, Tair
Wouters, Edwin
Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review
title Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review
title_full Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review
title_fullStr Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review
title_full_unstemmed Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review
title_short Social and Structural Determinants of Household Support for ART Adherence in Low- and Middle-Income Countries: A Systematic Review
title_sort social and structural determinants of household support for art adherence in low- and middle-income countries: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312869/
https://www.ncbi.nlm.nih.gov/pubmed/32471153
http://dx.doi.org/10.3390/ijerph17113808
work_keys_str_mv AT campbelllinda socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT masquilliercaroline socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT thunnissenestrelle socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT ariyoesther socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT tabanahanani socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT sematlaneneo socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT delportanton socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT dubelorrainetanyaradzwa socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT knightlucia socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT kasztanflechnertair socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview
AT woutersedwin socialandstructuraldeterminantsofhouseholdsupportforartadherenceinlowandmiddleincomecountriesasystematicreview