Factors associated with uptake of home-based HIV counselling and testing and HIV care services among identified HIV-positive persons in Masaka, Uganda
Bibliographic Data
| ID | 19443194 |
|---|---|
| Authors | Eugene Ruzagira (0000-0002-7291-1693, Department Infectious Disease and Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom, corresponding author), Kathy Baisley (0000-0003-1849-6625, Department Infectious Disease and Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom), Anatoli Kamali (MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda), Heiner Grosskurth (0000-0001-9960-7280, Department Infectious Disease and Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom) |
| Year | 2018 |
| Volume | 30 |
| Issue | 7 |
| Pages | 879-887 |
| Publication date | 2018-07-03 |
| 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 | 10.1080/09540121.2018.1441967 |
| PMID | 29463099 |
| OpenAlex | W2791534090 |
| Language | EN |
| Citations received | 2 |
| References cited | 24 |
We investigated uptake of home-based HIV counselling and testing (HBHCT) and HIV care services post-HBHCT in order to inform the design of future HBHCT programmes. We used data from an open-label cluster-randomised controlled trial which had demonstrated the effectiveness of a post-HBHCT counselling intervention in increasing linkage to HIV care. HBHCT was offered to adults (≥18 years) from 28 rural communities in Masaka, Uganda; consenting HIV-positive care naïve individuals were enrolled and referred for care. The trial's primary outcome was linkage to HIV care (clinic-verified registration for care) six months post-HBHCT. Random effects logistic regression was used to investigate factors associated with HBHCT uptake, linkage to care, CD4 count receipt, and antiretroviral therapy (ART) initiation; all analyses of uptake of post-HBHCT services were adjusted for trial arm allocation. Of 13,455 adults offered HBHCT, 12,100 (89.9%) accepted. HBHCT uptake was higher among men [adjusted odds ratio (aOR) 1.20, 95% confidence interval (CI) = 1.07-1.36] than women, and decreased with increasing age. Of 551 (4.6%) persons who tested HIV-positive, 205 (37.2%) were in care. Of those not in care, 302 (87.3%) were enrolled in the trial and of these, 42.1% linked to care, 35.4% received CD4 counts, and 29.8% initiated ART at 6 months post-HBHCT. None of the investigated factors was associated with linkage to care. CD4 count receipt was lower in individuals who lived ≥30 min from an HIV clinic (aOR 0.60, 95%CI = 0.34-1.06) versus those who lived closer. ART initiation was higher in older individuals (≥45 years versus <25 years, aOR 2.14, 95% CI = 0.98-4.65), and lower in single (aOR 0.60, 95% CI = 0.28-1.31) or divorced/separated/widowed (aOR 0.47, 95% CI = 0.23-0.93) individuals versus those married/cohabiting. HBHCT was highly acceptable but uptake of post-HBHCT care was low. Other than post-HBHCT counselling, this study did not identify specific issues that require addressing to further improve linkage to care
Family medicine · Adolescent Sexual and Reproductive Health · HIV/AIDS Impact and Responses · HIV/AIDS Research and Interventions · Medicine · Psychology · Gerontology
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| Citations per year | 0.25 |
|---|---|
| Citation span | 2018 - 2023 (6) |
| Highly cited | No |