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Global Health Facility-Based Interventions to Achieve UNAIDS 90-90-90: A Systematic Review and Narrative Analysis

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Abstract

To evaluate whether health facility-based HIV interventions align with UNAIDS 90-90-90 targets, we performed a systematic review through the lens of UNAIDS targets. We searched 11 databases, retrieving 5201 citations with 26 eligible studies classified by country income and UNAIDS target. We analyzed whether reporting of study outcome metrics was in line with UNAIDS targets using a standardized extraction form and results were summarized in a narrative synthesis given data heterogeneity. We also assessed the quality of randomized trials with the Cochrane Risk of Bias Tool and observational studies with the Newcastle–Ottawa Scale. Stratification of interventions by country income level revealed themes in successful interventions that provide insight for scale-up in similar resource contexts. Few studies reported outcomes using metrics according to UNAIDS targets. Standardization of reporting according to the UNAIDS framework could facilitate comparability of interventions and inform country-level progress on an international scale.

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Funding

The authors acknowledge the support of the following agencies: The Fonds de recherche du Québec-Santé Senior Award (NPP), the Canadian Institutes of Health Research grants HHP 137872 and PJT 153149 (NPP), and the Clinton Health Access Initiative (TP). The agencies had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Canada

    Clare Fogarty, Nick Karatzas, Sailly Dave, Nandi Belinsky & Nitika Pant Pai

  2. Clinton Health Access Initiative, Washington, DC, USA

    Trevor Peter

  3. Department of Medicine, McGill University, Montreal, QC, Canada

    Nitika Pant Pai

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  1. Clare Fogarty
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  2. Trevor Peter
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  3. Nick Karatzas
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  4. Sailly Dave
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Contributions

NPP and TP conceived the idea and research question. CF, SD, and NK extracted, screened and reviewed papers included in the systematic review, and performed the data analyses. CF drafted the manuscript. CF, NPP, SD, NK and NB contributed to editing and reviewing the final version of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Trevor Peter or Nitika Pant Pai.

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Fogarty, C., Peter, T., Karatzas, N. et al. Global Health Facility-Based Interventions to Achieve UNAIDS 90-90-90: A Systematic Review and Narrative Analysis. AIDS Behav 26, 1489–1503 (2022). https://doi.org/10.1007/s10461-021-03503-6

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