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Barreras al acceso al tratamiento antirretroviral: una revisión de estudios recientes en países en vías de desarrollo.
Author(s) -
Posse Mariana,
Meheus Filip,
Van Asten Henri,
Van Der Ven Andre,
Baltussen Rob
Publication year - 2008
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2008.02091.x
Subject(s) - developing country , medicine , population , health care , qualitative research , antiretroviral therapy , environmental health , human immunodeficiency virus (hiv) , family medicine , economic growth , sociology , social science , viral load , economics
Summary Objective To present a review of barriers impeding people living with HIV/AIDS in developing countries from accessing treatment, and to make recommendations for further studies. Methods Electronic databases, websites of main global agencies and international AIDS conferences were searched for relevant articles published between 1996 and 2007. Articles were reviewed using the Andersen and May framework of access to health services and barriers were categorized as either population‐level or health system‐level barriers. Results A total of 19 studies (7 articles and 12 abstracts) in English were reviewed. The barriers most frequently cited at the population level were lack of information about antiretroviral therapy (ART), perceived high costs for ART and stigma. Barriers most frequently cited at the health system level were long distance from home to the health facility, lack of co‐ordination across services and limited involvement of the community in the programme planning process. Conclusions Dissemination of information about HIV/AIDS and alternative related care, and alternative health financing policies seem to be the most relevant policy measures to remove barriers. In view of the paucity of evidence on barriers to access to ART, research should address the relative importance of barriers, include a mix of qualitative and quantitative research methods and evaluate barriers in different settings.