Evidence map›Paper›PMID 37068847›Full record

ArticleBMJ global health2023

Intergenerational spillover effects of antiretroviral therapy in sub-Saharan Africa: a scoping review and future directions for research.

Henning Schröder, H Manisha Yapa, Francesc Xavier Gómez-Olivé, Harsha Thirumurthy, Janet Seeley, Till Bärnighausen, Jan-Walter De Neve

Open access · goldAbstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 6 countries.

Henning SchröderHeidelberg Institute of Global Health, Medical Faculty, Heidelberg University, Heidelberg, Germany henning.schroeder@uni-heidelberg.de.
H Manisha YapaWestmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Francesc Xavier Gómez-OlivéMedical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Harsha ThirumurthyDepartment of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Janet SeeleyDepartment of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK.
Till BärnighausenHeidelberg Institute of Global Health, Medical Faculty, Heidelberg University, Heidelberg, Germany.
Jan-Walter De NeveHeidelberg Institute of Global Health, Medical Faculty, Heidelberg University, Heidelberg, Germany.ORCID 0000-0003-0090-8249
Heidelberg University · DELondon School of Hygiene & Tropical Medicine · GBThe University of Sydney · AUUniversity of Pennsylvania · USUniversity of the Witwatersrand · ZA

Funding

SOCIAL AND ECONOMIC PREDICTORS OF PHYSICAL AND COGNITIVE FUNCTIONP01AG041710 · NIA · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI LISA F BERKMAN, THOMAS A GAZIANO · 2013 to 2026
$37.3M
New Methods for the design and evaluation of large HIV prevention interventionsR01AI112339 · NIAID · YALE UNIVERSITY · PI SPIEGELMAN, DONNA L · 2014 to 2017
$2.7M
Causal Pathways to population health impact of HIV antiretroviral treatmentR01HD084233 · NICHD · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2015 to 2021
$2.3M
Can HIV Hot-Spots be eradicated? An intervention to decrease HIV transmission to young women in rural KwaZulu-Natal South AfricaR01AI124389 · NIAID · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2016 to 2020
$2.1M
Research Training on Harnessing Data Science for Global Health Priorities in AfricaU2RTW012140 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI BARNIGHAUSEN, TILL, FAWZI, WAFAIE W · 2021 to 2025
$1.7M
Investing In Secondary Schooling To Reduce HIV RiskR03HD098982 · NICHD · BOSTON UNIVERSITY MEDICAL CAMPUS · PI BOR, JACOB · 2019 to 2020
$165k
FIC NIH HHS U2R TW012140NIAID NIH HHS R01 AI112339NIAID NIH HHS R01 AI124389NIA NIH HHS P01 AG041710NICHD NIH HHS R01 HD084233NICHD NIH HHS R03 HD098982Wellcome Trust
6 · The paper itself

Abstract

backgroundAntiretroviral therapy (ART) may influence individuals who do not receive the intervention but who are connected in some way to the person who does. Relatively little is known, however, about the size and scope of, what we term, spillover effects of ART. We explored intergenerational spillover effects of ART in sub-Saharan Africa (SSA) and identified several directions for future research.

methodsWe conducted a scoping review between March and April 2022. We systematically searched PubMed, PsycINFO, EconLit, OTseeker, AIDSInfo, Web of Science, CINHAL, Google Scholar and African Index Medicus. We analysed the distribution of included studies over time and summarised their findings. We examined the intergenerational impact of ART provision to working-age adults living with HIV on children ('downward' spillover effects) and older adults ('upward' spillover effects). We categorised types of intergenerational spillover effects according to broad themes which emerged from our analysis of included studies.

findingsWe identified 26 studies published between 2005 and 2022 with 16 studies assessing spillover effects from adults to children (downward), and 1 study explicitly assessing spillover effects from working-age adults to older adults (upward). The remaining studies did not fully specify the direction of spillover effects. Most spillover effects of ART to household and family members were beneficial and included improvements in wealth, labour market outcomes, health outcomes and health services utilisation, schooling, and household composition. Both children and older adults benefited from ART availability among adults. Detrimental spillover effects were only reported in three studies and included financial and opportunity costs associated with health services utilisation and food insecurity in the first year after ART.

conclusionsART may lead to substantial spillover effects across generations and sectors in SSA. Further research is needed to capitalise on positive spillover effects while mitigating potential negative spillover effects. The returns to investments in large-scale health interventions such as ART may be underestimated without considering these societal benefits.

Indexed as

HIV InfectionsAfrica South of the SaharaAgedChildEducational StatusFamilyHumansPatient Acceptance of Health CareHIVPublic HealthReview

Identifiers

PMID37068847
PMCPMC10111905
OpenAlexW4366084711

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.