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item type: conferencePaper
is part of: Journal
publisher: communication orale
  type: Organization
  adr: Address
    locality: Cape Town
authors: Person
  surname: Nishimwe
  given name: Marie
authors: Person
  surname: Protopopescu
  given name: Camelia
authors: Person
  surname: Iwuji
  given name: Collins
authors: Person
  surname: Okesola
  given name: Nonhlanhla
authors: Person
  surname: Spire
  given name: Bruno
authors: Person
  surname: Orne-Gliemann
  given name: Joanna
authors: Person
  surname: McGrath
  given name: Nuala
authors: Person
  surname: Pillay
  given name: Deenan
authors: Person
  surname: Dabis
  given name: François
authors: Person
  surname: Larmarange
  given name: Joseph
authors: Person
  surname: Boyer
  given name: Sylvie
title: The impact of early ART initiation on HIV disclosure and social support among people living with HIV and followed within a universal test and treat programme in rural South Africa (ANRS 12249 TasP trial)
abstract: Aim HIV status disclosure and social support have been associated with increased antiretroviral treatment (ART) adherence and better clinical outcomes. We aimed to investigate the impact of early ART initiation on HIV status disclosure and social support among patients in care within the universal test and treat (UTT) cluster-randomized TasP trial conducted in rural South Africa between 2012 and 2016. Method/Issue Following home-based HIV testing, HIV-positive individuals were referred to trial clinics and offered ART regardless of CD4 in intervention arm or according to national guidelines (CD4≤350 cells/mm3 until December 2014, then ≤500 cells/mm3) in control arm. This analysis included patients not ART-treated at baseline (i.e. first clinic visit) and with CD4>500 cells/mm3 who attended at least two clinic visits. HIV disclosure and social support indexes (0-5) were estimated every 6 months: one point was attributed when HIV status was disclosed to - or when the patient reported social support from - at least one member of the following groups: regular partner, family, friends, neighbours, others. We used Poisson mixed effects models, adjusted on individual factors, exploring (i) the impact of time since baseline clinic visit, trial arm and interaction between arm and time; (ii) the impact of ART initiation (time-dependent); and (iii) interaction between arm and ART initiation. Results/Comments Of 3019 patients entering in care in trial clinics, 1597 were not on ART at baseline, 477 had CD4>500 cells/mm3 and 182 had at least two visits (93 in intervention, 89 in control arm). The 182 participants had a median [interquartile range (IQR)] follow-up duration of 13.2 [7.0-18.5] months. After 6 months, 22% had initiated ART in control arm versus 97% in intervention arm, while after 12 months they were 29% and 98% respectively. At baseline, median [IQR] HIV disclosure index was 2 [1;2] versus 1 [1;2] in intervention and control arms, respectively (p=0.361) and median […
presented at: AIDS Impact 13th International Conference
date: 2017-11-13
citation key: nishimweImpactEarlyART2017
rights: All rights reserved