Home-Based Care, the Missing Link in Caring of Patients Living with HIV/AIDS and Their Family Members: A Narrative Review.
Mona Larki, Robab Latifnejad Roudsari
PMID 32656272WHAT IT FOUND
Home-based HIV care was reported to improve adherence, household testing, access and family support, but included randomized trials also found no differences in CD4 counts, viral load, mood or quality of life.
Key findings
01Home-based care for people living with HIV was reported as a package including counseling and testing, antiretroviral adherence support, prevention of mother-to-child transmission, palliative care, nutrition, psychosocial support, and infection control.
02Nine included studies reported increased adherence to antiretroviral treatment, while an included randomized trial found no significant change in CD4 counts or viral load.
03Included studies reported that home-based care could improve household voluntary counseling and testing and identify undiagnosed infections; in a Uganda study, 74% of 176 HIV-positive family members tested had not been tested previously.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not assess the quality of the included studies. Included studies varied by country, design, participants, setting and resources, making results hard to combine. Only English and Persian articles were searched, so relevant articles in other languages may have been missed. No study on home-based care for people living with HIV in Iran was found. Home-based care was reported as a package of many components, so the review does not show which component caused any reported effect. Some randomized trials found no significant differences in CD4 counts, viral load, mood or quality of life.
The easy way to misread this
Do not read this as proof that home-based care improves HIV outcomes for all patients. It is a narrative review without quality assessment, and included randomized trials found no significant differences in CD4 counts, viral load, mood or quality of life.