Introduction: Structural interventions that guarantee antiretroviral treatment (ART) in com¬bination prevention are proposed to bridge the gap between testing and treatment, keeping people on the continuum of care.
Materials and Methods: A experiment that applies Law 19.966 of 2005 that grants treatment and financial protection to people living with HIV/AIDS (PLWHA) was used. Aggregated offi¬cial data from the Chilean Ministry of Health were used. An interrupted time-series design was used to determine the effect of the intervention on antiretroviral access, morbidity and morta¬lity, and AIDS cases. Additionally, the impact of the Law was evaluated with projections using an autoregressive moving average model (ARIMA), to contrast it with the observed cases.
Results: After 2005, the number of PLWHA on ART increased annually (2,268; 95% CI: 1502,23-3034,31), deaths from AIDS decreased (-17.6; 95% CI: -31,3- -3,8) and hospital discharges increased (70.86; 95% CI: 9.13-132.59). The projections indicated that, in the absence of the Law, an estimate of 99 321 PLWHA (P<0.001) would not have accessed ART and there would have been 657 more cases of AIDS (P<0.001).
Discussion: The GES Law achieved a substantial increase in PLWHA access to ART and a de¬crease in their morbidity and mortality linked to the increase in coverage. However, the decline in AIDS cases would be lower than expected due to gaps in the continuum of care for PLWHA.
Keywords:
health policy, highly active antiretroviral therapy, acquired immunodeficiency syndrome, health systems, Chile
Enríquez-Canto, Y., Díaz-Gervasi, G., Menacho-Alvirio, L., & Bravo-Barrera, M. (2021). Evaluation of the access to antiretrovirals by people living with HIV/AIDS under the Chilean law of explicit health guarantees, 1984-2018. Revista Chilena De Salud Pública, 25(1), p. 63–75. https://doi.org/10.5354/0719-5281.2021.65194
