{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:33:49Z","timestamp":1791563629209,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T00:00:00Z","timestamp":1783209600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010034","name":"Walailak University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010034","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sub\u2010Saharan Africa faces a syndemic of HIV and non\u2010communicable diseases (NCDs), particularly diabetes and hypertension. Integrated care models have been promoted to improve service efficiency and patient outcomes; however, evidence on their effectiveness, implementation and real\u2010world applicability remains fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review aimed to assess the clinical and service delivery effectiveness of integrated HIV\u2010diabetes\u2010hypertension care models in sub\u2010Saharan Africa and to identify key implementation barriers and facilitators, and sustainability considerations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review of studies published between January 2016 and June 2026 following PRISMA 2020 guidelines. PubMed, Scopus and African Index Medicus were searched. Eligible studies included randomized controlled trials, observational, qualitative and mixed\u2010method studies evaluating integrated care models for HIV and NCDs in sub\u2010Saharan Africa. Data were synthesized narratively, guided by implementation science frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen studies from eight sub\u2010Saharan African countries were included. Integrated care models, such as one\u2010stop clinics, nurse\u2010led service, adherence clubs and decentralized drug distribution, were consistently associated with high retention in care for people living with HIV (generally &gt;80%) and sustained viral suppression (&gt; 90%). Retention for diabetes and hypertension care was lower (70%\u201378%), and improvements in blood pressure and glycaemic control were reported but remained inconsistent and frequently suboptimal. Integrated care models improved service delivery outcomes, including appointment adherence, continuity of care and patient acceptability. Key implementation facilitators included task\u2010shifting, co\u2010located services, leadership support and leveraging existing HIV infrastructure. Common barriers were drug stockouts for NCDs, workforce shortages, fragmented data systems, stigma and confidentiality concerns, and long waiting times. Limited economic evidence indicates that personnel costs constituted the largest share of programme expenditure. While integrated care models were feasible and acceptable in routine settings, scalability and long\u2010term sustainability were constrained by donor dependence, supply chain weaknesses and variable health system readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrated HIV\u2010diabetes\u2010hypertension care models in sub\u2010Saharan Africa effectively maintain HIV treatment outcomes and improve service delivery, but clinical control of NCDs remains suboptimal. Sustainable and equitable integration will require deliberate strengthening of NCD\u2010specific supply chains, workforce training and context\u2010adapted implementation strategies aligned with health system readiness. Policy and programming should support differentiated, patient\u2010centred integration that addresses both clinical and systemic barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70159","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:32:59Z","timestamp":1783319579000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Integrated Care Models for HIV, Diabetes and Hypertension in Sub\u2010Saharan Africa: A Systematic Review of Effectiveness, Implementation and Real\u2010World Applicability"],"prefix":"10.1002","volume":"29","author":[{"given":"Charuai","family":"Suwanbamrung","sequence":"first","affiliation":[{"name":"Public Health Research Program School of Public Health Walailak University  Nakhon Si Thammarat Thailand"},{"name":"Excellent Center for Public Health Research (EC For PHR) Walailak University  Nakhon Si Thammarat Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esayas Aydiko","family":"Amele","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences Wolaita Sodo University  Wolaita Sodo Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dereje","family":"Haile","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences Wolaita Sodo University  Wolaita Sodo Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hien Thi","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Public Health Faculty Can Tho University of Medicine and Pharmacy  Can Tho Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9440-2622","authenticated-orcid":false,"given":"Temesgen Anjulo","family":"Ageru","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences Wolaita Sodo University  Wolaita Sodo Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30374-2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-575"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0281358"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01573-8"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10123-4"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2020.1750216"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26113"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/25787489.2024.2398869"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-078044"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001879"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/2633489520939980"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-024-02261-3"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.5588\/pha.24.0027"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053412"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08065-4"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09534-0"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-021-00387-3"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-023-02204-4"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-17043-2"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v13i1.2766"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05351-x"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0164634"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-036836"},{"key":"e_1_2_12_25_1","volume-title":"Guideline for the Pharmacological Treatment of Hypertension in Adults","author":"WHO","year":"2021"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70159","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.70159","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:08:14Z","timestamp":1784876894000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.70159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":24,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/jia2.70159"],"URL":"https:\/\/doi.org\/10.1002\/jia2.70159","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-12-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70159"}}