Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa

Diagnosing HIV and/or TB is not sufficient; linkage to care and treatment is conditional to reduce the burden of disease. This study aimed to determine factors associated with linkage to HIV care and TB treatment at community-based services in Cape Town, South Africa. This retrospective cohort study...

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Vydáno v:PloS one Ročník 13; číslo 4; s. e0195208
Hlavní autoři: Meehan, Sue-Ann, Sloot, Rosa, Draper, Heather R., Naidoo, Pren, Burger, Ronelle, Beyers, Nulda
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Public Library of Science 02.04.2018
Public Library of Science (PLoS)
Témata:
Acquired immune deficiency syndrome
Adult
Age
AIDS
AIDS treatment
Biology and Life Sciences
Care and treatment
Childrens health
Clients
Coinfection
Communities
Community Health Services
Delivery of Health Care - statistics & numerical data
Development and progression
Disease control
Disease Management
Disease prevention
Epidemics
Factor Analysis, Statistical
Female
Government agencies
Health care facilities
Health facilities
Health sciences
Health services
HIV
HIV Infections - diagnosis
HIV Infections - epidemiology
HIV Infections - therapy
Human immunodeficiency virus
Humans
Internet
Male
Mathematical models
Medical diagnosis
Medical tests
Medicine
Medicine and health sciences
Methods
Public health
Public Health Surveillance
Regression analysis
Regression models
Retrospective Studies
Serologic Tests
Sex
Sexually transmitted diseases
South Africa - epidemiology
STD
Studies
Tuberculosis
Tuberculosis - epidemiology
Tuberculosis - therapy
Tutu, Desmond
Young Adult
South Africa
Cape Town South Africa
ISSN:1932-6203, 1932-6203
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Shrnutí:Diagnosing HIV and/or TB is not sufficient; linkage to care and treatment is conditional to reduce the burden of disease. This study aimed to determine factors associated with linkage to HIV care and TB treatment at community-based services in Cape Town, South Africa. This retrospective cohort study utilized routinely collected data from clients who utilized stand-alone (fixed site not attached to a health facility) and mobile HIV testing services in eight communities in the City of Cape Town Metropolitan district, between January 2008 and June 2012. Clients were included in the analysis if they were ≥12 years and had a known HIV status. Generalized estimating equations (GEE) logistic regression models were used to assess the association between determinants (sex, age, HIV testing service and co-infection status) and self-reported linkage to HIV care and/or TB treatment. Linkage to HIV care was 3 738/5 929 (63.1%). Linkage to HIV care was associated with the type of HIV testing service. Clients diagnosed with HIV at mobile services had a significantly reduced odds of linking to HIV care (aOR 0.7 (CI 95%: 0.6-0.8), p<0.001. Linkage to TB treatment was 210/275 (76.4%). Linkage to TB treatment was not associated with sex and service type, but was associated with age. Clients in older age groups were less likely to link to TB treatment compared to clients in the age group 12-24 years (all, p-value<0.05). A large proportion of clients diagnosed with HIV at mobile services did not link to care. Almost a quarter of clients diagnosed with TB did not link to treatment. Integrated community-based HIV and TB testing services are efficient in diagnosing HIV and TB, but strategies to improve linkage to care are required to control these epidemics.
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Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: The last author was the principal Investigator of the co-operative agreement that supported the community-based HIV testing modalities described in this study. The first and fourth authors were involved in the management of the community-based HIV testing modalities described in this study. All data collection and interpretation was done according to good clinical practice. The other authors were not involved with the community-based HIV testing modalities in any way and declare that they have no competing interests.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0195208