Testing modality associated with fast-track ART initiation in Botswana.

Botswana HIV community-based testing index testing linkage test and start

Journal

Tropical medicine & international health : TM & IH
ISSN: 1365-3156
Titre abrégé: Trop Med Int Health
Pays: England
ID NLM: 9610576

Informations de publication

Date de publication:
05 2022
Historique:
pubmed: 18 3 2022
medline: 6 5 2022
entrez: 17 3 2022
Statut: ppublish

Résumé

The aim of this study was to identify community testing modalities associated with fast-track ART initiation in Botswana. We conducted a retrospective cohort study that included all Botswana citizens 15 years or older who were newly identified as HIV-positive from 1 May 2017 to 31 January 2019, in Mahalapye and Southern districts. We used Poisson regression with robust error variance and generalised linear mixed models to control for cluster effects to model risk of ART initiation within 7 and 30 days of HIV diagnosis, testing modality factors. A total of 1436 individuals were newly identified HIV-positive, with men accounting for 60% across all testing modalities. 22% of all HIV-positive individuals were initiated on ART within 7 days. Clients diagnosed through index testing were more likely to be started on ART within 7 days (adjusted risk ratio [aRR] = 1.38, 95% CI 1.37-1.38) and 30 days (aRR = 1.17, 95% CI 1.09-1.26) than those diagnosed through mobile/outreach testing. Community HIV testing can complement facility-based testing by reaching individuals who may be less likely to seek HIV services at a facility, such as men. Monitoring ART initiation by testing modalities is critical to identify the optimal ones and to guide continuous programme improvement.

Identifiants

pubmed: 35298082
doi: 10.1111/tmi.13745
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

537-543

Informations de copyright

© 2022 John Wiley & Sons Ltd.

Références

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Auteurs

Marie-Claude C Lavoie (MC)

Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA.

Natalia Blanco (N)

Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.

Koona Keapoletswe (K)

Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana.

Reson Marima (R)

Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana.

Ookeditse A Ntwayagae (OA)

Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana.

Kagiso B Sebina (KB)

Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana.

Peter Loeto (P)

Centers for Disease Control and Prevention, Gaborone, Botswana.

Panky G Mogomotsi (PG)

Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana.

Paul G Saleeb (PG)

Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.

Ndwapi Ndwapi (N)

Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana.

Kristen A Stafford (KA)

Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA.

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