The “4th 90” target as a strategy to improve health-related quality of life of people living with HIV in sub-Saharan Africa: a scoping review

Autor(en)
Prudence Tatiana Nti Mvilongo, Jef Vanhamel, Magdalena Siegel, Christiana Nöstlinger
Abstrakt


Objectives

Next to monitoring the clinical health of people living with HIV through the triple 90 targets, a 4th 90 target was proposed in 2016 to improve HIV health-related quality of life (HrQoL) by addressing comorbidities and other psychosocial challenges. This scoping review aimed at understanding related psychosocial determinants, including strategies to improve HrQoL for people living with HIV in sub-Saharan Africa (SSA), as an initiative to ameliorate the continuum of care.
Methods

This scoping review followed PRISMA guidelines. We searched PubMed and Wiley databases from 01 January 2011 to 19 April 2021 for articles on HrQoL, including determinants and related interventions in SSA. We also conducted a manual search to retrieve grey literature on the ‘4th 90’ target. The six domains of HrQoL defined in the most widely used instrument (i.e., WHOQOL-HIV-BREF tool) served as a guiding framework.
Results

Thirty-three articles were included for analysis. Seven articles illustrated the ongoing debate on the 4th 90 target, highlighting challenges with measuring indicators. Nine articles discussed HrQoL domains, reporting the highest scores in the spirituality and physical domains and lowest scores in the social and environmental domains. The presence of stigma and depressive symptoms was associated with low HrQoL. Seventeen articles discussed HrQoL interventions, highlighting that improved HrQoL enhanced health-seeking behaviour. Only two interventions addressed the environmental domain highlighting the fact that selection of intervention aims were not evidence led.
Conclusion

Introducing the 4th 90 target in SSA as a strategy to enhance HrQoL amongst people living with HIV could improve the HIV continuum of care; however, efforts are required to effectively address environmental and structural determinants.

Organisation(en)
Institut für Klinische und Gesundheitspsychologie
Externe Organisation(en)
Instituut voor Tropische Geneeskunde, Global Health Systems Solutions
Journal
Tropical Medicine and International Health
Band
27
Seiten
1026-1043
Anzahl der Seiten
18
ISSN
1365-3156
DOI
https://doi.org/10.1111/tmi.13825
Publikationsdatum
10-2022
Peer-reviewed
Ja
ÖFOS 2012
303031 Tropenmedizin
Schlagwörter
ASJC Scopus Sachgebiete
Public Health, Environmental and Occupational Health, Infectious Diseases, Parasitology
Sustainable Development Goals
SDG 3 – Gesundheit und Wohlergehen
Link zum Portal
https://ucris.univie.ac.at/portal/de/publications/the-4th-90-target-as-a-strategy-to-improve-healthrelated-quality-of-life-of-people-living-with-hiv-in-subsaharan-africa-a-scoping-review(b71e98d6-9e1a-4bf0-960a-13028935d3dd).html