普遍获得抗逆转录病毒治疗(ART)已成为治疗艾滋病毒感染者和实现流行病控制的全球标准；然而，来自撒哈拉以南非洲地区的大量“测试和治疗”试验和实施研究的发现表明，将“普遍”获得ART的规模比预期的要复杂得多。以南非为例，我们描述了有关扩大ART获取的文献中的研究重点和重点。要做到这一点，我们调整了Arksey和O'Malley的六阶段范围审查框架，以描述2000年至2017年间在南非扩大ART的同行评审文献和意见。数据收集包括系统搜索两个数据库和手工搜索参考列表的子样本。我们使用了一个适应的社会生态主题框架，根据数据在哪里定位扩大ART资格的挑战和机遇：个人/客户，卫生工作者-客户关系，诊所/社区背景，卫生系统基础设施和/或政策背景。我们纳入了194篇研究文章和23篇观点，1512年确定，解决南非扩大的ART准入问题。同行评审的文献侧重于个人和卫生系统基础设施；意见片侧重于改变个人的角色，社区和卫生服务实施者。我们通过与一组研究人员的协商过程将我们的发现背景化，艾滋病毒临床医生和方案管理人员考虑关键知识差距。与已出版的文献不同，随着南非艾滋病毒计划的扩大，协商过程提供了对研究和干预艾滋病毒服务提供的关系方面的重要性的特别见解。在有关南非扩大接受抗逆转录病毒疗法的已发表文献中，对个人和卫生系统基础设施因素的过分关注可能会使对艾滋病毒计划不足的理解偏离艾滋病毒服务提供的关系方面，并在寻找利用非医疗方式实现艾滋病毒流行病控制的方法方面拖延进展。
\'Universal\' access to antiretroviral treatment (ART) has become the global standard for treating people living with HIV and achieving epidemic control; yet, findings from numerous \'test and treat\' trials and implementation studies in sub-Saharan Africa suggest that bringing \'universal\' access to ART to scale is more complex than anticipated. Using South Africa as a case example, we describe the research priorities and foci in the literature on expanded ART access. To do so, we adapted Arksey and O\'Malley\'s six-stage scoping
review framework to describe the peer-reviewed literature and opinion pieces on expanding access to ART in South Africa between 2000 and 2017. Data collection included systematic searches of two databases and hand-searching of a sub-sample of reference lists. We used an adapted socio-ecological thematic framework to categorize data according to where it located the challenges and opportunities of expanded ART eligibility: individual/client, health worker-client relationship, clinic/community context, health systems infrastructure and/or policy context. We included 194 research articles and 23 opinion pieces, of 1512 identified, addressing expanded ART access in South Africa. The peer-reviewed literature focused on the individual and health systems infrastructure; opinion pieces focused on changing roles of individuals, communities and health services implementers. We contextualized our findings through a consultative process with a group of researchers, HIV clinicians and programme managers to consider critical knowledge gaps. Unlike the published literature, the consultative process offered particular insights into the importance of researching and intervening in the relational aspects of HIV service delivery as South Africa\'s HIV programme expands. An overwhelming focus on individual and health systems infrastructure factors in the published literature on expanded ART access in South Africa may skew understanding of HIV programme shortfalls away from the relational aspects of HIV services delivery and delay progress with finding ways to leverage non-medical modalities for achieving HIV epidemic control.
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