A new study developed a consensus statement to identify the key issues regarding HIV patients that should be addressed immediately.
The research has been published in the 'Nature Communications Journal'.
To guide stakeholders in improving health system responses to achieve the best possible long-term health outcomes for people living with HIV, a global multidisciplinary group of HIV experts led by CUNY SPH Senior Scholar Jeffrey Lazarus and including distinguished Professor Denis Nash and Associate Professor Diana Romero developed a consensus statement identifying the key issues health systems must address in order to move beyond the long-time emphasis on viral suppression to instead deliver integrated, person-centred healthcare for people living with HIV throughout their lives.
Following a rigorous, multi-stage Delphi process, the research team established a diverse panel of experts with expertise in the long-term health needs of people living with HIV. The panel reviewed the literature on multimorbidity and stigma and discrimination in order to identify priority issues to incorporate in the Delphi process to develop a consensus statement.
"An important strength of this consensus statement is that it was generated through this rigorous process, incorporating quantitative and qualitative data from experts from over 20 countries," said Dr Romero.
The panel found that multimorbidity, health-related quality of life, and stigma and discrimination continued to be major issues for people living with HIV, including those who have achieved viral suppression and in particular those from marginalized populations.
"These factors can lead to depression, social isolation, and barriers in accessing health and support services," said Dr Lazarus, who is also an associate professor at the Barcelona Institute for Global Health.
"Many of these issues are not currently addressed in HIV monitoring, strategies, or guideline," Lazarus added.
"There is ample evidence that addressing things like mental health, stigma reduction, quality of life, and in many settings, housing, and food security, will also improve HIV outcomes like adherence to antiretroviral medications and viral suppression," Dr Nash said.
"The field of HIV implementation science can play a key role in assessing the impact of strategies integrated into HIV service delivery to mitigate these issues," Nash added.
The World Health Organization (WHO) and UNAIDS should create new HIV monitoring processes and guidelines, and Member States should commit to reporting on the indicators and implement policies to enhance health system performance and ensure the long-term well-being of the millions of people around the world living with HIV, the authors noted.
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