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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
High HIV testing uptake and linkage to care in a novel program of home-based HIV counseling and testing with facilitated referral in KwaZulu-Natal, South Africa
Journal of Acquired Immune Deficiency Syndromes, Volume 64, No. 1, Year 2013
Notification
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Description
OBJECTIVE: For antiretroviral therapy (ART) to have a population-level HIV prevention impact, high levels of HIV testing and effective linkages to HIV care among HIV-infected persons are required. METHODS: We piloted home-based counseling and testing (HBCT) with point-of-care CD4 count testing and follow-up visits to facilitate linkage of HIV-infected persons to local HIV clinics and uptake of ART in rural KwaZulu-Natal, South Africa. Lay counselor follow-up visits at months one, three and six evaluated the primary outcome of linkage to care. Plasma viral load was measured at baseline and month six. RESULTS: 671 adults were tested for HIV (91% coverage) and 201 (30%) were HIV-infected, of which 73 (36%) were new diagnoses. By month three, 90% of HIV-infected persons not on ART at baseline had visited an HIV clinic and 80% of those eligible for ART at baseline by South African guidelines (CD4≤200 cells/μL at the time of the study) had initiated ART. Among HIV-infected participants who were eligible for ART at baseline, mean viral load decreased by 3.23 log10 copies/mL (p<0.001) and the proportion with viral load suppression increased from 20% to 80% between baseline and month six. CONCLUSIONS: In this pilot of HBCT and linkages to care in KwaZulu-Natal, 91% of adults were tested for HIV. Linkage to care was ∼90% both among newly-identified HIV-infected persons as well as known HIVinfected persons who were not engaged in care. Among those eligible for ART, a high proportion initiated ART and achieved viral suppression, indicating high adherence and reduced infectiousness. Copyright © 2013 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Van-Rooyen, Heidi E.
South Africa, Pretoria
Human Sciences Research Council of South Africa
Barnabas, Ruanne Vanessa
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Baeten, Jared M.
United States, Seattle
University of Washington
Phakathi, Zipho
South Africa, Pretoria
Human Sciences Research Council of South Africa
Joseph, Philip G.
South Africa, Pretoria
Human Sciences Research Council of South Africa
Krows, Meighan L.
United States, Seattle
University of Washington
Hong, Ting
United States, Seattle
University of Washington
Murnane, Pamela M.
United States, Seattle
University of Washington
Hughes, James P.
United States, Seattle
Fred Hutchinson Cancer Research Center
United States, Seattle
University of Washington
Celum, Connie L.
United States, Seattle
University of Washington
Statistics
Citations: 144
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0b013e31829b567d
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa