The impact of water, sanitation, and hygiene interventions on the health and well-being of people living with HIV: a systematic review

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Travis YatesRobert Quick

Abstract

Access to improved water supply and sanitation is poor in low-income and middle-income countries. Persons living with HIV/AIDS (PLHIV) experience more severe diarrhea, hospitalizations, and deaths from diarrhea because of waterborne pathogens than immunocompetent populations, even when on antiretroviral therapy (ART). We examined the existing literature on the impact of water, sanitation, and hygiene (WASH) interventions on PLHIV for these outcomes: (1) mortality, (2) morbidity, (3) retention in HIV care, (4) quality of life, and (5) prevention of ongoing HIV transmission. Cost-effectiveness was also assessed. Relevant abstracts and articles were gathered, reviewed, and prioritized by thematic outcomes of interest. Articles meeting inclusion criteria were summarized in a grid for comparison. We reviewed 3355 citations, evaluated 132 abstracts, and read 33 articles. The majority of the 16 included articles focused on morbidity, with less emphasis on mortality. Contaminated water, lack of sanitation, and poor hygienic practices in homes of PLHIV increase the risk of diarrhea, which can result in increased viral load, decreased CD4 counts, and reduced absorption of nutrients and antiretroviral medication. We found WASH programming...Continue Reading

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Citations

Jan 19, 2016·Frontiers in Physiology·Arun Chaudhury
Dec 14, 2018·International Journal of Environmental Research and Public Health·Chao WangShangfeng Tang
Apr 12, 2019·International Journal of Environmental Research and Public Health·Chao WangDechao Yao

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