Motivations and Barriers to Treatment Uptake and Adherence Among People Living with HIV in Australia: A Mixed-Methods Systematic Review

In Australia, approximately 30% of people diagnosed with HIV are not accessing treatment and 8% of those receiving treatment fail to achieve viral suppression. Barriers limiting effective care warrant further examination. This mixed-methods systematic review accessed health and social sector research databases between November and December 2015 to identify studies that explored the perspective of people living with HIV in Australia. Articles were included for analysis if they described the experiences, knowledge, attitudes and beliefs, in relation to treatment uptake and adherence, published between January 2000 and December 2015. Quality appraisal utilised the Mixed Methods Appraisal Tool Version 2011. Seventy-two studies that met the inclusion criteria were reviewed. The interplay of lack of knowledge, fear, stigma, physical, emotional and social issues were found to negatively impact treatment uptake and adherence. Strategies targeting both the individual and the wider community are needed to address these barriers.ResumenEn Australia, aproximadamente el 30% de las personas diagnosticadas con VIH no están accediendo al tratamiento; el 8% de los que han recibido el tratamiento no logran alcanzar niveles de supresión viral total. Las barreras que limitan la prestación de una atención médica integral y eficaz, necesitan ser examinadas detenidamente. Se realizó una revisión sistemática de los estudios que exploraron la perspectiva de las personas viviendo con VIH en Australia. Se utilizaron métodos mixtos para acceder a bases de datos de investigación en salud y del sector social entre noviembre y diciembre de 2015. Los artículos que se incluyeron para el análisis debían describir experiencias, conocimientos, actitudes y creencias, en relación a la adopción del tratamiento y adherencia al mismo, publicados entre enero de 2000 y diciembre del 2015. La evaluación de la calidad de los artículos utilizó la herramienta de evaluación de métodos mixta, versión 2011. Se revisaron setenta y dos estudios que cumplieron los criterios de inclusión. Las interacciones entre la falta de conocimiento, miedo, estigma, así como problemas físicos, emocionales y sociales produjeron un impacto negativo en la adopción y adherencia al tratamiento. Se necesitan estrategias dirigidas a los individuos, así como a la comunidad en general para hacer frente a estas barreras.

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