期刊
AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV
卷 33, 期 1, 页码 70-79出版社
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/09540121.2020.1719025
关键词
Community-based HIV testing services; home-based HIV testing services; linkage to care; antiretroviral therapy; HIV treatment cascade; Southern Africa
类别
资金
- Centers for Disease Control and Prevention (CDC) [3U2GGH000372]
- National Research Foundation, South Africa, through the Research Career Advancement Fellowship
- South Africa-U.S. Program for Collaborative Biomedical Research, National Institutes of Health [R01HD083343]
- Epicentre [3U2GGH000372]
Early initiation of ART is crucial, but there are often challenges in linking individuals to care following community-based services. Factors influencing linkage to care following home-based HIV-testing services in a hyper-endemic area in South Africa were examined in this study, with results indicating the need for targeted interventions to facilitate early engagement with healthcare services.
Early antiretroviral therapy (ART) initiation is essential, but linkage to care following community-based services is often poor, and inadequately understood. This study examined factors influencing linkage to care following home-based HIV-testing services (HBHTS) in a hyper-endemic setting in South Africa. HBHTS was offered to participants (N = 10,236) enrolled in the second HIV Incidence Provincial Surveillance System survey (2015-2016), KwaZulu-Natal. Follow-up telephone surveys with 196 of the 313 individuals diagnosed HIV-positive through HBHTS were used to measure linkage to care (i.e., a clinic visit within 12 weeks) and ART-initiation. Among newly diagnosed individuals (N = 183), 55% linked to care, and 21% of those who were ART-eligible started treatment within 12 weeks. Linkage to care was less likely among participants who had doubted their HIV-diagnosis (aOR:0.46, 95%CI: 0.23-0.93) and more likely among participants who had disclosed their HIV-status (aOR:2.31, 95%CI: 1.07-4.97). Reasons for not linking to care included no time (61%), only wanting to start treatment when sick (48%), fear of side-effects (33%), and not believing the HIV-diagnosis (16%). Results indicate that HBHTS needs to be paired with targeted interventions to facilitate early linkage to care. Interventions are required to counter denial of HIV status and facilitate early linkage to care among healthier individuals.
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