Setting and organization of care for persons living with HIV/AIDS

Policy makers and health workers need evidence about how and where to provide care for people living with HIV/AIDS. This review identified 28 studies involving 39,776 study subjects that examined these questions. Centres with a lot of HIV/AIDS patients often had lower death rates. The number of patients needed to get these results was very different in each study so it is not clear what the right number is. Settings with case management had fewer deaths and had higher use of antiretroviral medications. There were several other promising interventions to increase antiretroviral use (using several health interventions at the same time and using computerized reminders), to reduce hospital admissions (using multiple health disciplines and increasing hours of operation), and reducing length of hospital stay (telephone notices and advice for providers). Unfortunately, the design of these studies, the small number of studies on each intervention and the lack of standard terms and definitions limits their usefulness to health providers and policy-makers. This is especially true for developing countries as no studies were found from those settings.