Evidence map›Paper›PMID 40432580›Full record

SynthesisHIV medicine2025

Free antiretrovirals as a key tool against the HIV pandemic: A systematic review.

Melissa Doutre, Marie-Pier Godin, Iliya Dmitriev, Ana Paula Pena-Gralle, Amy Bergeron, Lucie Blais, Benoît Lemire

Abstract readSystematic Review
In one paragraph

Synthesis in HIV medicine, 2025. 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
–field-weighted citation impact
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.

  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.

Melissa DoutreFaculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
Marie-Pier GodinFaculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
Iliya DmitrievFaculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
Ana Paula Pena-GralleFaculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
Amy BergeronHealth Library, University of Montreal, Montreal, Quebec, Canada.ORCID https://orcid.org/0000-0002-4224-0307
Lucie BlaisFaculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
Benoît LemirePharmacy Department, McGill University Health Centre, Montreal, Quebec, Canada.ORCID https://orcid.org/0000-0003-1363-7687

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesAccess to antiretroviral (ARV) drugs remains a critical challenge in achieving the WHO/UNAIDS 95-95-95 targets, with medication costs representing a substantial barrier. This systematic review evaluates the effect of free ARVs, without out-of-pocket cost to the patient, on the HIV cascade of care: the use of ARV therapy, viral suppression and the use of prophylaxis (PrEP).

methodsThe following databases were searched for publications between 1 January 1996 and 10 July 2024: MEDLINE, Embase, CINAHL, CNKI, Global Index Medicus, the Web of Science, the SciELO Citation Index and grey literature. Publications were eligible if they included people living with or at risk of HIV and compared free access to ARVs with out-of-pocket fees. Reviewers screened publications that focused on the outcomes: being on therapy, being virally suppressed and being on PrEP. The National Heart, Lung and Blood Institute (NHLBI) and Joanna Briggs Institute (JBI) Quality Assessment Tools were used to assess publication quality.

resultsA total of 34164 documents were identified, and 407 full-text manuscripts were reviewed. A total of 22 publications met the inclusion criteria. In six of the seven publications reporting on being on therapy, providing free ARVs increased the number of people who received treatment. All four publications reporting on viral suppression showed improvement with free access. Additionally, both publications reporting on PrEP use showed increased utilization with free access.

conclusionsThe review offers valuable insights for countries considering implementing free ARV programmes. It suggests that expanding access to free ARVs helps achieve the global HIV targets and improve health outcomes.

Indexed as

Anti-HIV AgentsAnti-Retroviral AgentsHIV InfectionsHealth Services AccessibilityHumansPandemicsPre-Exposure ProphylaxisAnti-HIV AgentsAnti-Retroviral Agents95‐95‐95 targetsantiretroviral therapycost‐sharingHIVpre‐exposure prophylaxissystematic review

Identifiers

PMID40432580
PMCPMC12400491

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.