Edinburgh Napier University

  Background/aims: In 2018, an estimated 37.9 million people globally were living with HIV. These people often experience physical, psychological, social and spiritual symptoms and concerns which impact on their quality of life (QoL) and retention in care. In order to fully achieve the 90-90-90 HIV treatment targets, UNAIDS advocates for community-based care delivery to increase access to care and person-centred and holistic care to support people living with HIV (PLWH) to remain in care and on treatment. We aimed to appraise the evidence of person-centred models of community HIV care and their impact on outcomes for PLWH.
Methods: A systematic review was conducted in line with PRISMA guideline. Six electronic databases (CINAHL, Embase, PubMed, Medline, PsycINFO and Web of Science) were searched from January 1980 to April 2019, using pre-defined search terms, with hand searching of reference lists of included studies to identify additional studies. We included primary studies of any designs for adults aged ⩾15 years and person-centred care (PCC) models that is delivered or led by formally trained healthcare professionals (HCP). PCC models (physical, psychological, social and spiritual) were extracted including authors, study location, design, quality, results and effectiveness
Results: 9 out of 1,393 studies met the inclusion criteria, of which, 8 were from a high income country and 1 from a lower-middle income country. Study designs included pilot & feasibility studies n=3, qualitative observational studies n=3, survey designs n=2 & a RCT n=1. 762 PLWH and 89 HCP participants were include in the 9 studies retained; and only 2 studies delivered all 4 PCC models (physical, psychological, social and spiritual), with only 1 study using validated outcome measures, which reported positive effects on self-reported mental health related QoL and psychosocial wellbeing.
Conclusions: Few studies delivered PCC models for PLWH which improved their health-related QoL and wellbeing. Future studies should focus more on PCC for PLWH.