Microfinance Interventions and HIV Treatment Outcomes: A Synthesizing Conceptual Framework and Systematic Review
- PMID: 30805757
- PMCID: PMC6708758
- DOI: 10.1007/s10461-019-02443-6
Microfinance Interventions and HIV Treatment Outcomes: A Synthesizing Conceptual Framework and Systematic Review
Abstract
Background: Microfinance interventions have the potential to improve HIV treatment outcomes, but the mechanisms through which they operate are not entirely clear.
Objectives: To construct a synthesizing conceptual framework for the impact of microfinance interventions on HIV treatment outcomes using evidence from our systematic review.
Methods: We conducted a systematic review by searching electronic databases and journals from 1996 to 2018 to assess the effects of microfinance interventions on HIV treatment outcomes, including adherence, retention, viral suppression, and CD4 cell count.
Results: All studies in the review showed improved adherence, retention, and viral suppression, but varied in CD4 cell count following participation in microfinance interventions-overall supporting microfinance's positive role in improving HIV treatment outcomes. Our synthesizing conceptual framework identifies potential mechanisms through which microfinance impacts HIV treatment outcomes through hypothesized intermediate outcomes.
Conclusion: Greater emphasis should be placed on assessing the effect mechanisms and intermediate behaviors to generate a sound theoretical basis for microfinance interventions.
Antecedentes:: Las intervenciones de microfinanzas tienen el potencial de mejorar los resultados del tratamiento del VIH, pero los mecanismos a través de los cuales operan no están del todo claros.
Objetivos:: Construir un marco conceptual de síntesis del impacto de las intervenciones de microfinanzas en los resultados del tratamiento del VIH utilizando evidencia de una revisión sistemática.
Métodos:: Se llevó a cabo una revisión sistemática mediante búsquedas en bases de datos electrónicas y revistas desde 1996 hasta 2018 para evaluar los efectos de las intervenciones de microfinanzas en los resultados del tratamiento del VIH, incluida la adherencia, la retención, la supresión viral y el recuento de células CD4.
Resultados:: Todos los estudios en la revisión mostraron una mejor adherencia, retención y supresión viral, pero variaron en el recuento de células CD4 luego de la participación en las intervenciones de microfinanzas, lo que respalda el papel positivo de las microfinanzas en la mejora de los resultados del tratamiento del VIH. El marco conceptual de síntesis propuesto identifica los mecanismos potenciales a través de los cuales las microfinanzas impactan los resultados del tratamiento del VIH a través de resultados intermedios hipotéticos.
Conclusión:: Se debe poner mayor énfasis en evaluar los mecanismos de efecto y los comportamientos intermedios para generar una base teórica sólida para las intervenciones de microfinanzas.
Keywords: Adherence; Conceptual framework; HIV treatment outcomes; Intermediate outcomes; Microfinance.
Conflict of interest statement
Conflict of Interest: The authors declare that they have no conflict of interest.
Figures
Similar articles
-
Treatment interruptions predict resistance in HIV-positive individuals purchasing fixed-dose combination antiretroviral therapy in Kampala, Uganda.AIDS. 2007 May 11;21(8):965-71. doi: 10.1097/QAD.0b013e32802e6bfa. AIDS. 2007. PMID: 17457090 Clinical Trial.
-
Microfinance: a general overview and implications for impoverished individuals living with HIV/AIDS.J Health Care Poor Underserved. 2010 Aug;21(3):986-1005. doi: 10.1353/hpu.0.0326. J Health Care Poor Underserved. 2010. PMID: 20693740 Review.
-
Supporting Treatment Adherence Readiness through Training (START) for patients with HIV on antiretroviral therapy: study protocol for a randomized controlled trial.Trials. 2016 Mar 24;17:162. doi: 10.1186/s13063-016-1287-3. Trials. 2016. PMID: 27009061 Free PMC article. Clinical Trial.
-
Clinical and Economic Effects of a Pharmacist-Administered Antiretroviral Therapy Adherence Clinic for Patients Living with HIV.J Manag Care Spec Pharm. 2018 Feb;24(2):165-172. doi: 10.18553/jmcp.2018.24.2.165. J Manag Care Spec Pharm. 2018. PMID: 29384024 Free PMC article.
-
Is microfinance associated with changes in women's well-being and children's nutrition? A systematic review and meta-analysis.BMJ Open. 2019 Jan 28;9(1):e023658. doi: 10.1136/bmjopen-2018-023658. BMJ Open. 2019. PMID: 30696674 Free PMC article.
Cited by
-
Feasibility and impact of a patient support group care model on diabetes and hypertension care in informal settlements in Nairobi, Kenya: a quasi-experimental study.Glob Health Action. 2025 Dec;18(1):2482304. doi: 10.1080/16549716.2025.2482304. Epub 2025 Apr 9. Glob Health Action. 2025. PMID: 40200831 Free PMC article.
-
Microfinance, retention in care, and mortality among patients enrolled in HIV care in East Africa.AIDS. 2021 Oct 1;35(12):1997-2005. doi: 10.1097/QAD.0000000000002987. AIDS. 2021. PMID: 34115646 Free PMC article.
-
Poor outcomes among critically ill HIV-positive patients at hospital discharge and post-discharge in Guinea, Conakry: A retrospective cohort study.PLoS One. 2023 Mar 13;18(3):e0281425. doi: 10.1371/journal.pone.0281425. eCollection 2023. PLoS One. 2023. PMID: 36913379 Free PMC article.
-
Integrated community-based HIV and non-communicable disease care within microfinance groups in Kenya: study protocol for the Harambee cluster randomised trial.BMJ Open. 2021 May 18;11(5):e042662. doi: 10.1136/bmjopen-2020-042662. BMJ Open. 2021. PMID: 34006540 Free PMC article.
-
Social, economic and food insecurity among people living with HIV in Kenya during coinciding public health and environmental emergencies: a mixed-methods study.BMJ Public Health. 2024 Sep 23;2(2):e000836. doi: 10.1136/bmjph-2023-000836. eCollection 2024 Dec. BMJ Public Health. 2024. PMID: 40018611 Free PMC article.
References
-
- MacPherson E, Desmond N, Mwapasa V, Lalloo DG, Seeley J, Theobald S. Exploring the complexity of microfinance and HIV in fishing communities on the shores of Lake Malawi. Malawi-Liverpool-Wellcome Trust Clin Res Program. 2015;30096(3). http://lshtmtest.da.ulcc.ac.uk/992527/1/MacPherson-finalversion.pdf. Accessed April 18, 2018.
-
- Swann M AIDS Care Psychological and Socio-medical Aspects of AIDS/HIV Economic strengthening for retention in HIV care and adherence to antiretroviral therapy: a review of the evidence Economic strengthening for retention in HIV care and adherence to antiretroviral therapy: a review of the evidence. AIDS Care. 2018;30(S3):99–125. doi:10.1080/09540121.2018.1479030org/10.1080/09540121.2018.1479030 - DOI - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials