Effective interventions to improve young adults’ linkage to HIV care in Sub-Saharan Africa: a systematic review

ABSTRACT

HIV/AIDS remains a major public health problem despite the efforts to prevent and decrease its spread. Sub-Saharan Africa (SSA) represents 70% of the global number of people living with HIV and 73% of all HIV/AIDS-related deaths. Young adults age 15–24 years are disproportionately impacted by HIV/AIDS in SSA with 34% of people living with HIV (PLWHIV) and 37% of newly diagnosed individuals being in this age group. It is important that PLWHIV be linked to care to facilitate antiretroviral therapy (ART) initiation and limit the spread of infection. We conducted a systematic literature review to identify effective interventions designed to improve linkage to care among HIV-infected young adults in SSA. One hundred and forty-six titles and abstracts were screened, 28 full-texts were reviewed, and 6 articles met the inclusion and exclusion criteria. Home-based HIV counseling and testing, home-based HIV self-testing, and mobile HIV counseling and testing followed by proper referral of HIV-positive patients to HIV care were effective for improving linkage of young adults to care. Other factors such as referral forms, transportation allowance, home initiation of HIV care, and volunteer escort to the HIV treatment clinic were effective in reducing time to linkage to care. There is a vast need for research and interventions that target HIV-positive young adults in SSA which aim to improve their linkage and access to HIV care. The results of this study illustrate effective interventions in improving linkage to care and reducing time to linkage to care of young adults in SSA.

KEYWORDS:

• HIV/AIDS
• linkage to care
• Sub-Saharan Africa
• young adults

Acknowledgements

For her help in suggesting search terminology and more efficient ways to search databases, the authors wish to acknowledge Ms. Xan Goodman, Health Sciences Librarian, UNLV. This research is a systematic review of published literature and deemed excluded by the UNLV Institutional Review Board (IRB). Informed consent was not obtained as this was a systematic review of published literature.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was partly funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Mental Health, and the U.S. President’s Emergency Plan for AIDS Relief under [award number R01HD075050].