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Integrated surveillance of HIV care in low-income and middle-income countries

Tassie, Jean-Michel; Bertagnolio, Silvia; Souteyrand, Yves

Current Opinion in HIV and AIDS: July 2011 - Volume 6 - Issue 4 - p 233–238
doi: 10.1097/COH.0b013e328347798d
Cohort analysis of clinical and treatment outcomes: Edited by Carolyn Williams, Matthew Law and François Dabis

Purpose of review HIV care should be seen as a continuum of health interventions that starts from HIV testing and counselling and ends with life-long provision of antiretroviral therapy (ART). All the interventions should be monitored with appropriate methods and indicators to constitute an integrated surveillance system of HIV care. This review outlines the different elements of this comprehensive surveillance, highlighting their public health importance.

Recent findings Data on HIV care programmes in developing countries are generally fragmented and weak, focusing primarily on outcomes of patients on ART. A global scale-up of ART should be accompanied by robust programmatic assessment of the whole spectrum of HIV care components, which include monitoring pre-ART and ART programmatic elements, routine surveillance of HIV drug resistance, pharmacovigilance and appropriate surveillance of HIV-related mortality.

Summary Comprehensive surveillance of HIV care that integrates multiple elements is needed in order to provide evidence-based data to optimize quality of care and improve survival. However, due to the increasing number of patients, the need for life-long interventions and the weakness of the health system, the implementation and sustainability of an integrated surveillance programme is challenging.

Department of HIV/AIDS, World Health Organization, Geneva, Switzerland

Correspondence to Jean-Michel Tassie, HTM/HIV/SIR, World Health Organization, 20, Avenue Appia, 1211 Geneva 27, Switzerland Tel: +41 22 791 34 70; fax: +41 22 791 15 75; e-mail: tassiej@who.int

© 2011 Lippincott Williams & Wilkins, Inc.