Factors associated with antiretroviral treatment initiation amongst HIV-positive individuals linked to care within a universal test and treat programme
Early findings of the ANRS 12249 TasP trial in rural South Africa
Bibliographic Data
| ID | 19443141 |
|---|---|
| Authors | Simon Boyer (0000-0002-7567-5200, Inserm, corresponding author), Collins Iwuji (0000-0003-2045-1717, Africa Health Research Institute), Andréa Gosset (0000-0003-0743-2458, Inserm), Camelia Protopopescu (0000-0003-0164-7917, Inserm), Nonhlanhla Okesola (Africa Health Research Institute), Mélanie Plazy (0000-0002-8971-6878, Université de Bordeaux), Bruno Spire (0000-0002-3546-8020, Inserm), Joanna Orne-Gliemann (0000-0003-0359-4089, Université de Bordeaux), Nicky Mcgrath (0000-0002-1039-0159, Africa Health Research Institute), Deenan Pillay (0000-0003-3640-2573, Faculty (United Kingdom)), François Dabis (0000-0002-1614-8857, Université de Bordeaux), Joseph Larmarange (0000-0001-7097-700X, Université Paris Cité) |
| Year | 2016 |
| Volume | 28 |
| Issue | sup3 |
| Pages | 39-51 |
| Publication date | 2016-06-02 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | AIDS Care (JOURNAL) |
| Journal identifiers | ISSN: 0954-0121 • E-ISSN: 1360-0451 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/09540121.2016.1164808 |
| PMID | 27421051 |
| OpenAlex | W2426257378 |
| Language | EN |
| Citations received | 11 |
| References cited | 31 |
Prompt uptake of antiretroviral treatment (ART) is essential to ensure the success of universal test and treat (UTT) strategies to prevent HIV transmission in high-prevalence settings. We describe ART initiation rates and associated factors within an ongoing UTT cluster-randomized trial in rural South Africa. HIV-positive individuals were offered immediate ART in the intervention arm vs. national guidelines recommended initiation (CD4≤350 cells/mm(3)) in the control arm. We used data collected up to July 2015 among the ART-eligible individuals linked to TasP clinics before January 2015. ART initiation rates at one (M1), three (M3) and six months (M6) from baseline visit were described by cluster and CD4 count strata (cells/mm(3)) and other eligibility criteria: ≤100; 100-200; 200-350; CD4>350 with WHO stage 3/4 or pregnancy; CD4>350 without WHO stage 3/4 or pregnancy. A Cox model accounting for covariate effect changes over time was used to assess factors associated with ART initiation. The 514 participants had a median [interquartile range] follow-up duration of 1.08 [0.69; 2.07] months until ART initiation or last visit. ART initiation rates at M1 varied substantially (36.9% in the group CD4>350 without WHO stage 3/4 or pregnancy, and 55.2-71.8% in the three groups with CD4≤350) but less at M6 (from 85.3% in the first group to 96.1-98.3% in the three other groups). Factors associated with lower ART initiation at M1 were a higher CD4 count and attending clinics with both high patient load and higher cluster HIV prevalence. After M1, having a regular partner was the only factor associated with higher likelihood of ART initiation. These findings suggest good ART uptake within a UTT setting, even among individuals with high CD4 count. However, inadequate staffing and healthcare professional practices could result in prioritizing ART initiation in patients with the lowest CD4 counts
Antiretroviral therapy · Family medicine · Interquartile range · Pregnancy · Viral load · Demography · HIV Research and Treatment · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Internal Medicine · Pediatrics
The trial multiple
Exploring the willingness toward HIV immediate test and treat among MSM in Nairobi and its environs
A social innovation to empower community-led monitoring and mobilization for HIV prevention in rural Kenya
Motivating people living with HIV to initiate antiretroviral treatment outside national guidelines in three clinics in the HPTN 071 (PopART) trial, South Africa
A Risk Prediction Model to Identify People Living with HIV Who are High-risk for Disengagement from Care after HIV Diagnosis in South Africa
Understanding the Reasons for Deferring ART Among Patients Diagnosed Under the Same-Day-ART Policy in Johannesburg, South Africa
Test and Treat’ Among Women at High Risk for HIV-infection in Kampala, Uganda
Duration Since Never in HIV Care and Immediate Blood-Draw After HIV Diagnosis are Associated with Willingness to Link to Care Following Health Department Outreach, New York City
Factors Influencing Rapid Antiretroviral Therapy Initiation at Four eThekwini Clinics, KwaZulu-Natal, South Africa
Individual and healthcare supply-related barriers to treatment initiation in HIV-positive patients enrolled in the Cameroonian antiretroviral treatment access programme
Mediating immediacy in the era of 'treat all
A 4-item measure of depression and anxiety
The health and health system of South Africa
An Ultra-Brief Screening Scale for Anxiety and Depression
Proportional hazards tests and diagnostics based on weighted residuals
Heterosexual HIV-1 transmission after initiation of antiretroviral therapy
High Coverage of ART Associated with Decline in Risk of HIV Acquisition in Rural KwaZulu-Natal, South Africa
A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa
Prevention of HIV-1 Infection with Early Antiretroviral Therapy
Addressing social issues in a universal HIV test and treat intervention trial (ANRS 12249 TasP) in South Africa
Validity of rapid estimates of household wealth and income for health surveys in rural Africa
Non-adherence to antiretroviral treatment and unplanned treatment interruption among people living with HIV/Aids in Cameroon
| Citations per year | 1.22 |
|---|---|
| Citation span | 2017 - 2027 (11) |
| Highly cited | No |