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dc.contributor.authorLópez Varela, Elisa-
dc.contributor.authorFuente Soro, Laura-
dc.contributor.authorAugusto, Orvalho-
dc.contributor.authorSacoor, Charfudin-
dc.contributor.authorNhacolo, Ariel-
dc.contributor.authorKarajeanes, Esmeralda-
dc.contributor.authorVaz, Paula-
dc.contributor.authorNaniche, Denise-
dc.description.abstractINTRODUCTION: 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.-
dc.format.extent9 p.-
dc.publisherLippincott, Williams & Wilkins-
dc.relation.isformatofReproducció del document publicat a:
dc.relation.ispartofJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 2018, vol. 78, num. 5, p. 527-535-
dc.relation.uri 10.1097/QAI.0000000000001720-
dc.rightscc by-nc-nd (c) López Varela, 2018-
dc.subject.classificationVIH (Virus)-
dc.subject.otherHIV (Viruses)-
dc.titleContinuum of HIV Care in Rural Mozambique: The Implications of HIV Testing Modality on Linkage and Retention-
Appears in Collections:Articles publicats en revistes (ISGlobal)

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