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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Rapid point-of-care CD4 testing at mobile HIV testing sites to increase linkage to care: An evaluation of a pilot program in South Africa
Journal of Acquired Immune Deficiency Syndromes, Volume 61, No. 2, Year 2012
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Description
BACKGROUND: A mobile HIV counseling and testing (HCT) program around Johannesburg piloted the integration of point-of-care (POC) CD4 testing, using the Pima analyzer, to improve linkages to HIV care. We report results from this pilot program for patients testing positive (n = 508) from May to October 2010. METHODS: We analyzed 3 primary outcomes: assignment to testing group (offered POC CD4 or not), successful follow-up (by telephone), and completed the referral visit for HIV care within 8 weeks after HIV testing if successfully followed up. Proportions for each outcome were calculated, and relative risks were estimated using a modified Poisson approach. RESULTS: Three hundred eleven patients were offered the POC CD4 test, and 197 patients were not offered the test. No differences in patient characteristics were observed between the 2 groups. Approximately 62.7% of patients were successfully followed up 8 weeks after HIV testing, with no differences observed between testing groups. Among those followed up, 54.4% reported completing their referral visit. Patients offered the POC CD4 test were more likely to complete the referral visit for further HIV care (relative risk 1.25, 95% confidence interval: 1.00 to 1.57). CONCLUSIONS: In this mobile HCT setting, patients offered POC CD4 testing as part of the HCT services were more likely to visit a referral clinic after testing, suggesting that rapid CD4 testing technology may improve linkage to HIV care. Future research can evaluate options for adjusting HCT services if POC CD4 testing was included permanently and the cost-effectiveness of the POC CD4 testing compared with other approaches for improving linkage of care. Copyright © 2012 by Lippincott Williams &Wilkins.
Authors & Co-Authors
Larson, Bruce A.
United States, Boston
School of Public Health
Schnippel, Kathryn
South Africa, Johannesburg
University of the Witwatersrand
Ndibongo, Buyiswa
South Africa, Johannesburg
University of the Witwatersrand
Xulu, Thembi
South Africa, Johannesburg
Right to Care
Brennan, Alana T.
United States, Boston
School of Public Health
South Africa, Johannesburg
University of the Witwatersrand
Long, Lawrence C.
United States, Boston
School of Public Health
Fox, Matthew P.
United States, Boston
School of Public Health
South Africa, Johannesburg
University of the Witwatersrand
Rosen, Sydney B.
United States, Boston
School of Public Health
South Africa, Johannesburg
University of the Witwatersrand
Statistics
Citations: 111
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0b013e31825eec60
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
South Africa