Linkage to HIV care and early retention in HIV care among men in the 'universal test-and-treat' era in a high HIV-burdened district, KwaZulu-Natal, South Africa.
HIV treatment
Linkage to care
Men
Retention in care
South Africa
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
02 Apr 2024
02 Apr 2024
Historique:
received:
10
12
2022
accepted:
16
02
2024
medline:
2
4
2024
pubmed:
2
4
2024
entrez:
2
4
2024
Statut:
epublish
Résumé
Despite the numerous efforts and initiatives, males with HIV are still less likely than women to receive HIV treatment. Across Sub-Saharan Africa, men are tested, linked, and retained in HIV care at lower rates than women, and South Africa is no exception. This is despite the introduction of the universal test-and-treat (UTT) prevention strategy anticipated to improve the uptake of HIV services. The aim of this study was to investigate linkage to and retention in care rates of an HIV-positive cohort of men in a high HIV prevalence rural district in KwaZulu-Natal province, South Africa. From January 2018 to July 2019, we conducted an observational cohort study in 18 primary health care institutions in the uThukela district. Patient-level survey and clinical data were collected at baseline, 4-months and 12-months, using isiZulu and English REDCap-based questionnaires. We verified data through TIER.Net, Rapid mortality survey (RMS), and the National Health Laboratory Service (NHLS) databases. Data were analyzed using STATA version 15.1, with confidence intervals and p-value of ≤0.05 considered statistically significant. The study sample consisted of 343 male participants diagnosed with HIV and who reside in uThukela District. The median age was 33 years (interquartile range (IQR): 29-40), and more than half (56%; n = 193) were aged 18-34 years. Almost all participants (99.7%; n = 342) were Black African, with 84.5% (n = 290) being in a romantic relationship. The majority of participants (85%; n = 292) were linked to care within three months of follow-up. Short-term retention in care (≤ 12 months) was 46% (n = 132) among men who were linked to care within three months. While the implementation of the UTT strategy has had positive influence on improving linkage to care, men's access of HIV treatment remains inconsistent and may require additional innovative strategies.
Identifiants
pubmed: 38561736
doi: 10.1186/s12913-024-10736-3
pii: 10.1186/s12913-024-10736-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
384Subventions
Organisme : CDC HHS
ID : 1U2GGH001150
Pays : United States
Organisme : CDC HHS
ID : 1U2GGH001150
Pays : United States
Organisme : CDC HHS
ID : 1U2GGH001150
Pays : United States
Organisme : CDC HHS
ID : 1U2GGH001150
Pays : United States
Organisme : CDC HHS
ID : 1U2GGH001150
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
UNAIDS. Blind spot: reaching out to men and boys. Addressing a blind spot in the response to HIV. Geneva, Switzerland: UNAIDS; 2017.
Staveteig S, Wang S, Head SK, Bradley SE, Nybro E. Demographic patterns of HIV testing uptake in sub-saharan Africa. ICF International Calverton, MD; 2013.
Kaplan SR, Oosthuizen C, Stinson K, Little F, Euvrard J, Schomaker M, et al. Contemporary disengagement from antiretroviral therapy in Khayelitsha, South Africa: a cohort study. PLoS Med. 2017;14(11):e1002407.
doi: 10.1371/journal.pmed.1002407
pubmed: 29112692
pmcid: 5675399
Hlongwa M, Mashamba-Thompson T, Makhunga S, Hlongwana K. Barriers to HIV testing uptake among men in sub-saharan Africa: a scoping review. Afr J AIDS Res. 2020;19(1):13–23.
doi: 10.2989/16085906.2020.1725071
pubmed: 32174231
Sharma M, Barnabas RV, Celum C. Community-based strategies to strengthen men’s engagement in the HIV care cascade in sub-saharan Africa. PLoS Med. 2017;14(4):e1002262.
doi: 10.1371/journal.pmed.1002262
pubmed: 28399122
pmcid: 5388461
UNAIDS. Understanding Fast-track: accelerating action to end the AIDS epidemic by 2030. UNAIDS; 2015.
Druyts E, Dybul M, Kanters S, Nachega J, Birungi J, Ford N, et al. Male sex and the risk of mortality among individuals enrolled in antiretroviral therapy programs in Africa: a systematic review and meta-analysis. Aids. 2013;27(3):417–25.
doi: 10.1097/QAD.0b013e328359b89b
pubmed: 22948271
Tsai AC, Siedner MJ. The missing men: HIV treatment scale-up and life expectancy in sub-saharan Africa. PLoS Med. 2015;12(11):e1001906.
doi: 10.1371/journal.pmed.1001906
pubmed: 26599825
pmcid: 4658175
Barnighausen T, Herbst AJ, Tanser F, Newell M, Bor J, editors. Unequal benefits from ART: a growing male disadvantage in life expectancy in rural South Africa. Conference on retroviruses and opportunistic infections; 2014.
World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Geneva: World Health Organization; 2016.
SA National Department of Health. Implementation of the Universal Test and treat strategy for HIV positive patients and differentiated care for stable patients. Pretoria: Department of Health, Directorate DC; 2016.
Haber N, Tanser F, Bor J, Naidu K, Mutevedzi T, Herbst K, et al. From HIV infection to therapeutic response: a population-based longitudinal HIV cascade-of-care study in KwaZulu-Natal, South Africa. Lancet HIV. 2017;4(5):e223–e30.
doi: 10.1016/S2352-3018(16)30224-7
pubmed: 28153470
pmcid: 5964602
Colasanti J, Kelly J, Pennisi E, Hu Y-J, Root C, Hughes D, et al. Continuous retention and viral suppression provide further insights into the HIV care continuum compared to the cross-sectional HIV care cascade. Clin Infect Dis. 2016;62(5):648–54.
doi: 10.1093/cid/civ941
pubmed: 26567263
Statistics South Africa, General Household Survey. 2019. Pretoria, South Africa: Statistics South Africa; 2020.
South Africa District HIV estimates [Internet]. 2020. Available from: https://www.hivdata.org.za/
Osler M, Hilderbrand K, Hennessey C, Arendse J, Goemaere E, Ford N, et al. A three-tier framework for monitoring antiretroviral therapy in high HIV burden settings. J Int AIDS Soc. 2014;17(1):18908.
doi: 10.7448/IAS.17.1.18908
pubmed: 24780511
pmcid: 4005043
Nicol E, Basera W, Mukumbang FC, Cheyip M, Mthethwa S, Lombard C et al. Linkage to HIV care and early retention in care rates in the universal test-and-treat era: a population-based prospective study in KwaZulu-Natal, South Africa. AIDS Behav. 2022:1–14.
Hlongwa M, Jama NA, Mehlomakulu V, Pass D, Basera W, Nicol E. Barriers and facilitating factors to HIV treatment among men in a high-HIV-burdened district in KwaZulu-Natal, South Africa: a qualitative study. Am J Men’s Health. 2022;16(5):15579883221120987.
doi: 10.1177/15579883221120987
Huerga H, Van Cutsem G, Farhat JB, Puren A, Bouhenia M, Wiesner L, et al. Progress towards the UNAIDS 90-90-90 goals by age and gender in a rural area of KwaZulu-Natal, South Africa: a household-based community cross-sectional survey. BMC Public Health. 2018;18(1):1–8.
doi: 10.1186/s12889-018-5208-0
Meehan S-A, Sloot R, Draper HR, Naidoo P, Burger R, Beyers N. Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa. PLoS ONE. 2018;13(4):e0195208.
doi: 10.1371/journal.pone.0195208
pubmed: 29608616
pmcid: 5880394
Maman D, Ben-Farhat J, Chilima B, Masiku C, Salumu L, Ford N, et al. Factors associated with HIV status awareness and linkage to care following home based testing in rural Malawi. Tropical Med Int Health. 2016;21(11):1442–51.
doi: 10.1111/tmi.12772
Lippman SA, El Ayadi AM, Grignon JS, Puren A, Liegler T, Venter WF, et al. Improvements in the South African HIV care cascade: findings on 90-90‐90 targets from successive population‐representative surveys in North West Province. J Int AIDS Soc. 2019;22(6):e25295.
doi: 10.1002/jia2.25295
pubmed: 31190460
pmcid: 6562149
Govindasamy D, Ford N, Kranzer K. Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review. Aids. 2012;26(16):2059–67.
doi: 10.1097/QAD.0b013e3283578b9b
pubmed: 22781227
Nicol E, Mehlomakulu V, Jama NA, Hlongwa M, Basera W, Pass D, et al. Healthcare provider perceptions on the implementation of the universal test-and-treat policy in South Africa: a qualitative inquiry. BMC Health Serv Res. 2023;23(1):1–11.
doi: 10.1186/s12913-023-09281-2
Anglaret X, Minga A, Gabillard D, Ouassa T, Messou E, Morris B, et al. AIDS and non-AIDS morbidity and mortality across the spectrum of CD4 cell counts in HIV-infected adults before starting antiretroviral therapy in Cote d’Ivoire. Clin Infect Dis. 2012;54(5):714–23.
doi: 10.1093/cid/cir898
pubmed: 22173233
Grinsztejn B, Hosseinipour MC, Ribaudo HJ, Swindells S, Eron J, Chen YQ, et al. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial. Lancet Infect Dis. 2014;14(4):281–90.
doi: 10.1016/S1473-3099(13)70692-3
pubmed: 24602844
pmcid: 4144040
Conan N, Coulborn RM, Simons E, Mapfumo A, Apollo T, Garone DB, et al. Successes and gaps in the HIV cascade of care of a high HIV prevalence setting in Zimbabwe: a population-based survey. J Int AIDS Soc. 2020;23(9):e25613.
doi: 10.1002/jia2.25613
pubmed: 32969602
pmcid: 7513352
Hirasen K, Fox MP, Hendrickson CJ, Sineke T, Onoya D. HIV treatment outcomes among patients initiated on antiretroviral therapy pre and post-universal test and treat guidelines in South Africa. Ther Clin Risk Manag. 2020;16:169.
Cornell M, McIntyre J, Myer L. Men and antiretroviral therapy in Africa: our blind spot. Tropical Med Int Health. 2011;16(7):828–9.
doi: 10.1111/j.1365-3156.2011.02767.x
Mberi MN, Kuonza LR, Dube NM, Nattey C, Manda S, Summers R. Determinants of loss to follow-up in patients on antiretroviral treatment, South Africa, 2004–2012: a cohort study. BMC Health Serv Res. 2015;15(1):1–11.
doi: 10.1186/s12913-015-0912-2
Alvarez-Uria G, Naik PK, Pakam R, Midde M. Factors associated with attrition, mortality, and loss to follow up after antiretroviral therapy initiation: data from an HIV cohort study in India. Global Health Action. 2013;6(1):21682.
doi: 10.3402/gha.v6i0.21682
pubmed: 24028937
Loeliger KB, Niccolai LM, Mtungwa LN, Moll A, Shenoi SV. Antiretroviral therapy initiation and adherence in rural South Africa: community health workers’ perspectives on barriers and facilitators. AIDS Care. 2016;28(8):982–93.
doi: 10.1080/09540121.2016.1164292
pubmed: 27043077
pmcid: 4917424
Osler M, Hilderbrand K, Goemaere E, Ford N, Smith M, Meintjes G, et al. The continuing burden of advanced HIV disease over 10 years of increasing antiretroviral therapy coverage in South Africa. Clin Infect Dis. 2018;66(suppl2):118–S25.
doi: 10.1093/cid/cix1140