Improving access to health care is essential to reduce the incidence of HIV


Many patients living with HIV in rural areas of Africa do not receive regular treatment, despite recent efforts to increase access to health care across the continent.

Researchers at the University of Cincinnati found that 28% of HIV-positive patients aged 15 and over in East and Southern Africa and 42% of patients in West and Central Africa were not receiving the latest antiretroviral therapy.

The results demonstrate the challenges of serving rural populations, particularly during the COVID-19 pandemic. The study concluded that improving access to health care is key to reducing the incidence of HIV.

Large numbers of people living with HIV in Africa lack treatment and care, especially the latest antiretroviral therapy, due to limited health-related resources. “

Hana Kim, Senior Study Author and PhD Candidate, College of Arts and Sciences, University of Cincinnati

The study was published in the journal PLOS Global Public Health.

Africa is geographically larger than many people realize. The United States could integrate three times inside Africa. Providing health care to rural people is a particularly daunting challenge, Kim said.

African countries not only have disproportionate geography, but also HIV rates that are disproportionate to global averages. HIV infection remains one of the leading causes of death in sub-Saharan Africa, which has the highest number of new infections in the world.

The United Nations AIDS Program in 2015 announced a goal of boosting HIV diagnosis and treatment by 2020 with the goal of ending the scourge of AIDS by 2030. The effort recognized that a Expanded access to treatment is crucial for success.

“Access to the nearest health facility is one of the most important measures for successful HIV treatment,” said co-author Diego Cuadros, assistant professor and director of Health Geography and Disease Modeling UC Lab.

“Viral suppression is very important because these HIV positive people with viral suppression are healthy people who are also not infectious and therefore do not transmit the disease,” he said.
In contrast, those who do not receive treatment are much more likely to fall ill or even die and pass the disease on to others, Cuadros said.

The study is an international collaboration between UC and scientists from Zimbabwe and Dubai as well as Oregon State University.

The researchers created maps of sub-Saharan Africa identifying populations living within 10, 30 and 60 minutes on foot or by car. They found that 1.5 million people living with HIV lived more than an hour’s drive from the nearest health facility.

The study identified disparities in the availability of care between countries. People living in over 90% of Sudan and Mauritania had to drive more than an hour to get to health services.

In 17 countries, about half of the population living with HIV live in places with limited access to health care, according to the study.

And in Kenya, Rwanda and Burundi, hardly anyone has to drive more than an hour to get to the nearest clinic, doctor’s office or hospital for treatment.

The study concluded that expanding healthcare in these underserved communities could improve not only the response to HIV, but also the response to the COVID-19 pandemic and other public health issues.

“The massive global COVID-19 health crisis and associated travel restrictions have presented enormous challenges for accessibility to health care for people living with HIV,” the study found. “Unfortunately, people living with HIV are at a higher risk of infection with COVID-19 and they suffer from more acute symptoms than the general population due to a weakened immune system and a lack of access to services. health.”

Another consideration is the transport infrastructure in rural Africa. Kim said public transport is not readily available in some rural areas, while storm-damaged roads and bridges may temporarily limit access. Mobile health care has often filled the void in these areas, she said.

“This strategy has already worked in some African countries such as Malawi and South Africa,” Kim said.

Cuadros said the pandemic had disrupted many of these mobile strategies over the past two years.

“HIV-related health outcomes are expected to deteriorate over the past year in Africa,” Cuadros said

Source:

Journal reference:

Kim, H., et al. (2021) When Distance Matters: Mapping Underserved Communities in HIV-Related Health Care in Sub-Saharan Africa. PLOS Global Public Health. doi.org/10.1371/journal.pgph.0000013.

About Bradley J. Bridges

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