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Title: Continuum of HIV Care in Rural Mozambique: The Implications of HIV Testing Modality on Linkage and Retention
Author: López Varela, Elisa
Fuente Soro, Laura
Augusto, Orvalho
Sacoor, Charfudin
Nhacolo, Ariel
Karajeanes, Esmeralda
Vaz, Paula
Naniche, Denise
Keywords: VIH (Virus)
HIV (Viruses)
Issue Date: 1-Aug-2018
Publisher: Lippincott, Williams & Wilkins
Abstract: INTRODUCTION: Context-specific improvements in the continuum of HIV care are needed in order to achieve the UNAIDS target of 90-90-90. This study aimed to assess the linkage to and retention in HIV care according to different testing modalities in rural southern Mozambique. METHODS: Adults newly diagnosed with HIV from voluntary counseling and testing (VCT), provider-initiated (PICT) and home-based HIV testing (HBT) services were prospectively enrolled between 2014- 2015 at the Manhica District. Patients were passively followed-up through chart examination .Tracing was performed at 12-months to ascertain causes of loss to follow-up. Fine and Grey competing risk analysis was performed to determine factors associated with the each step of the cascade. RESULTS: Overall linkage to care as defined by having a CD4 count at 3 months, was 43.7% (95CI% 40.8-46.6) and 25.2% of all participants initiated ART. Factors associated with increased linkage in multivariable analysis included testing at VCT, older age, having been previously tested for HIV, owning a cell phone, presenting with WHO clinical stages III/IV, self-reported illness-associated disability in the previous month , and later calendar month of participant recruitment. Ascertaining deaths and transfers allowed adjustment of the rate of 12-month retention in treatment from 75.6% (95% CI 70.2-80.5) to 84.2% (95% CI 79.2-88.5). CONCLUSIONS: HBT reached a socio-demographically distinct population from that of clinic based testing modalities but low linkage to care points to a need for facilitated linkage interventions. Distinguishing between true treatment defaulting and other causes of loss-to-follow-up can significantly change indicators of retention in care.
Note: Reproducció del document publicat a:
It is part of: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 2018, vol. 78, num. 5, p. 527-535
Related resource: 10.1097/QAI.0000000000001720
ISSN: 1525-4135
Appears in Collections:Articles publicats en revistes (ISGlobal)

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