{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:03:34Z","timestamp":1790287414673,"version":"4.1.0"},"reference-count":72,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Access to antiretroviral (ARV) drugs remains a critical challenge in achieving the WHO\/UNAIDS 95\u201095\u201095 targets, with medication costs representing a substantial barrier. This systematic review evaluates the effect of free ARVs, without out\u2010of\u2010pocket cost to the patient, on the HIV cascade of care: the use of ARV therapy, viral suppression and the use of prophylaxis (PrEP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 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\u2010of\u2010pocket 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 34164 documents were identified, and 407 full\u2010text 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70051","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T04:13:02Z","timestamp":1748405582000},"page":"1329-1342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Free antiretrovirals as a key tool against the\n                    <scp>HIV<\/scp>\n                    pandemic: A systematic review"],"prefix":"10.1111","volume":"26","author":[{"given":"Melissa","family":"Doutre","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy University of Montreal  Montreal Quebec Canada"},{"name":"Pharmacy Department McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Pier","family":"Godin","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy University of Montreal  Montreal Quebec Canada"},{"name":"Pharmacy Department McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iliya","family":"Dmitriev","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Montreal  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula","family":"Pena\u2010Gralle","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy University of Montreal  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-0307","authenticated-orcid":false,"given":"Amy","family":"Bergeron","sequence":"additional","affiliation":[{"name":"Health Library University of Montreal  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Blais","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy University of Montreal  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1363-7687","authenticated-orcid":false,"given":"Beno\u00eet","family":"Lemire","sequence":"additional","affiliation":[{"name":"Pharmacy Department McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"UNAIDS.2023 Report. UNAIDS \u2010 Global Report 2023. n.d. accessed October 14 2024.https:\/\/thepath.unaids.org\/"},{"key":"e_1_2_9_3_1","unstructured":"HIV and AIDS. n.d. Accessed October 24 2024.https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids"},{"key":"e_1_2_9_4_1","unstructured":"Consolidated guidelines on HIV prevention testing treatment service delivery and monitoring: recommendations for a public health approach. n.d. Accessed October 26 2024.https:\/\/www.who.int\/publications\/i\/item\/9789240031593"},{"key":"e_1_2_9_5_1","unstructured":"Summary: HIV antiretroviral medication coverage in Canada 2023. Accessed October 26 2024.https:\/\/www.canada.ca\/en\/public\u2010health\/services\/publications\/diseases\u2010conditions\/summary\u2010hiv\u2010antiretroviral\u2010medication\u2010coverage.html"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.7108"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/107755870105800102"},{"key":"e_1_2_9_8_1","unstructured":"Cost Considerations and Antiretroviral Therapy | NIH.2024. Accessed October 24 2024.https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/hiv\u2010clinical\u2010guidelines\u2010adult\u2010and\u2010adolescent\u2010arv\/antiretroviral\u2010therapy\u2010cost\u2010considerations"},{"key":"e_1_2_9_9_1","unstructured":"Out\u2010of\u2010pocket costs associated with HIV in publicly funded high\u2010income health care settings \u2013 The Ontario HIV Treatment Network 2024. Accessed October 24 2024.https:\/\/www.ohtn.on.ca\/out\u2010of\u2010pocket\u2010costs\u2010associated\u2010with\u2010hiv\u2010in\u2010publicly\u2010funded\u2010high\u2010income\u2010health\u2010care\u2010settings\/"},{"key":"e_1_2_9_10_1","unstructured":"European PrEP programmes face two big issues: how to get more people coming forward and how to serve them if they do. AidsmapCom.2021. Accessed November 30 2023.https:\/\/www.aidsmap.com\/news\/jan\u20102021\/european\u2010prep\u2010programmes\u2010face\u2010two\u2010big\u2010issues\u2010how\u2010get\u2010more\u2010people\u2010coming\u2010forward\u2010and"},{"key":"e_1_2_9_11_1","unstructured":"Brazil has been at the forefront of HIV treatment and prevention in Latin America says the scientific journal. n.d. Accessed November 3 2024.https:\/\/www.unodc.org\/lpo\u2010brazil\/en\/frontpage\/2018\/02\/brazil\u2010has\u2010been\u2010at\u2010the\u2010forefront\u2010of\u2010hiv\u2010treatment\u2010and\u2010prevention\u2010in\u2010latin\u2010america\u2010\u2010says\u2010the\u2010scientific\u2010journal\u2010.html"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6849a1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238720"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12897"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2014.934654"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/tru130"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010023\u201004225\u20107"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0136664"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000232245.36039.2b"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_21_1","unstructured":"Free HIV Drugs as a Key Tool Against the HIV Pandemic \u2010 A Systematic Review. n.d. Accessed July 15 2024.https:\/\/app.covidence.org\/reviews\/324139\/extraction\/index"},{"key":"e_1_2_9_22_1","unstructured":"BergeronA.Search strategies for \u201cFree HIV Drugs as a Key Tool Against the HIV Pandemic: A Systematic Review\u201d.2024.10.5683\/SP3\/YNSEEA"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010020\u201001542\u2010z"},{"key":"e_1_2_9_24_1","unstructured":"NHLBI NIH.Study Quality Assessment Tools. n.d. Accessed October 24 2024.https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools"},{"key":"e_1_2_9_25_1","unstructured":"The revised JBI critical appraisal tool for the assessment of risk of bias for quasi\u2010experimental studies \u2010 PubMed. n.d. Accessed October 24 2024.https:\/\/pubmed.ncbi.nlm.nih.gov\/38287725\/"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3549(04)50159-0"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31820a9d04"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix380"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0285326"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001078"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003790"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2023.00808"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2021.04.008"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000645"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26194"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2021.07.002"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(21)00074\u20106"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/09564624211054587"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20103156.2011.02867.x"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(06)68337\u20102"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.2471\/blt.07.044248"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26161"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2009.01.009"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102334\u201011\u201031"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102431\u20109\u201080"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2007.12.007"},{"key":"e_1_2_9_47_1","unstructured":"\u5b81\u6ce2\u5e02HIV\u611f\u67d3\u8005\u6297\u75c5\u6bd2\u6cbb\u7597\u533b\u7597\u4fdd\u9669\u836f\u7269\u4f7f\u7528\u60c5\u51b5\u53ca\u76f8\u5173\u56e0\u7d20\u5206\u6790 \u2010 \u4e2d\u534e\u6d41\u884c\u75c5\u5b66\u6742\u5fd7. n.d. Accessed July 15 2024.https:\/\/rs.yiigle.com\/cmaid\/1489672"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070375"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010019\u201002493\u2010w"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545109706288722"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.4067\/s0034\u201098872018000300290"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010009\u20109663\u20106"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2016.24.144.6004"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwz252"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/1758\u20102652\u201014\u201032"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1086\/431199"},{"key":"e_1_2_9_57_1","unstructured":"Impact of universal coverage for antiretroviral therapy (ART) on health outcomes \u2013 The Ontario HIV Treatment Network 2024. Accessed October 24 2024.https:\/\/www.ohtn.on.ca\/rapid\u2010response\u2010impact\u2010of\u2010universal\u2010coverage\u2010for\u2010antiretroviral\u2010therapy\u2010art\u2010on\u2010health\u2010outcomes\/"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/964512"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(17)30540\u20106"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.02.005"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2023.2233824"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2012.0419"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010017\u20101869\u20104"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2022.11.096"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010021\u201003571\u20108"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1294966"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.02.044"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019\u2010557X.77256"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001987"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030\u2010200317003\u201000014"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283463eec"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31825eb27b"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1813728"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T10:45:08Z","timestamp":1756723508000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":72,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/hiv.70051"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70051","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]},"assertion":[{"value":"2025-03-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}