title: Interventions to reduce mortality in sub-Saharan Africa among HIV-infected adults not yet on antiretroviral therapy.
abstract: Where antiretroviral therapy is available, the primary source of mortality among HIV-infected people is the delay in starting treatment. Many of these delays occur in the context of care and are modifiable through changes in the protocols followed by healthcare providers for HIV testing, staging and preparation of patients for antiretroviral therapy. A number of potential evidence-based interventions are discussed in the context of sub-Saharan Africa. Included are decentralizing services, initiating counseling on antiretroviral therapy without delay, tracing patients that miss appointments, protecting patient confidentiality, reducing user fees, and providing point-of-care tests for CD4 cell counts, cryptococcal antigen, and for the diagnosis of TB.
authors.affiliation: Institute for Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium. kpeterson@itg.be
authors.forename: Kevin
authors.initials: K
authors.lastname: Peterson
authors.forename: Johan
authors.initials: J
authors.lastname: van Griensven
authors.forename: Diana
authors.initials: D
authors.lastname: Huis in 't Veld
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
mesh_terms: D015492:AIDS Serodiagnosis; D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000401:mortality; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003219:Confidentiality; D037001:Directive Counseling; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality; D006297:Health Services Accessibility; D006801:Humans; D059012:Lost to Follow-Up; D010349:Patient Compliance; D013997:Time Factors
chemical_list: D044966:Anti-Retroviral Agents