A scoping review of the role of community programs in sustaining integrated HIV and health services

Community programs are essential for addressing persistent inequalities that perpetuate significant HIV-related disparities across various regions worldwide. However, the absence of a systematic framework for analyzing the role of community programs in HIV prevention and antiretroviral therapy (ART) monitoring impedes our ability to understand and study their effectiveness amid scarce health professional resources. This scoping review aimed to map and synthesize available evidence on the role of community programs in driving sustainable integrated HIV and health services, examining their impact on various interventions along the HIV care continuum. Following Joanna Briggs Institute (JBI) guidelines, we conducted a comprehensive literature search of PubMed/MEDLINE, Science Direct, Google Scholar, and relevant gray literature sources for peer-reviewed articles published between January 2014 and December 2024. Search strategies incorporated Boolean operators and Medical Subject Headings (MeSH) terms related to community programs and HIV services. Two reviewers independently screened records, extracted data, and resolved discrepancies through a consensus. The review adhered to the PRISMA-ScR reporting guidelines. The initial search yielded 392 records. After removing duplicates ( n = 87) and screening titles and abstracts ( n = 305), 48 full-text articles were assessed for eligibility. 12 studies met the inclusion criteria and were included in the final review. All included studies reported positive roles for community programs across various aspects of ART programs. Three studies (25%) highlighted the ability of community programs to mobilize resources, advocate for access to treatment, and monitor ART service delivery. Two studies (16.7%) demonstrated that community programs can expand HIV/AIDS interventions and ensure a seamless continuum of services from testing to care and treatment. Two additional studies (16.7%) emphasized the importance of community programs in empowering patients to manage their own care. Findings from this scoping review suggest that integrating community programs into HIV and health services represents a potentially effective strategy to address health workforce shortages and improve service accessibility. Decentralizing HIV services through community-based initiatives can increase access to essential health services, including ART. However, the evidence base of this scoping review remains limited by the small number of included studies, heterogeneous designs, and variable quality of evidence. More rigorous research is needed to assess effectiveness, cost-effectiveness, sustainability, and scalability across diverse settings.