Entry into care following universal home-based HIV testing in rural KwaZulu-Natal, South Africa: the ANRS TasP 12249 cluster-randomised trial
item type: conferencePaper
is part of: Journal
publisher: communication orale n°WEAD0103
  type: Organization
  adr: Address
    locality: Vancouver
authors: Person
  surname: Plazy
  given name: Mélanie
authors: Person
  surname: El Farouki
  given name: Kamal
authors: Person
  surname: Iwuji
  given name: Collins
authors: Person
  surname: Okesola
  given name: Nonhlanhla
authors: Person
  surname: Orne-Gliemann
  given name: Joanna
authors: Person
  surname: Larmarange
  given name: Joseph
authors: Person
  surname: Newell
  given name: Marie-Louise
authors: Person
  surname: Pillay
  given name: Deenan
authors: Person
  surname: Dabis
  given name: François
authors: Person
  surname: Dray-Spira
  given name: Rosemary
authors: Person
  surname: ANRS 12249 TasP Study Group
abstract: Background: In a Universal Test and Treat (UTT) strategy, entry into care soon after HIV diagnosis is crucial to achieve optimal population-antiretroviral treatment (ART) coverage. We evaluated the rate of, and factors associated with, entry into care following home-based HIV testing in a cluster-randomised trial of the effect of immediate ART on HIV incidence in rural KwaZulu-Natal, South Africa. Methods: From March 2012 to May 2014, individuals ≥16 years in ten (2 x 5) clusters were offered home-based HIV testing; those ascertained HIV-positive were referred to TasP trial clinics and were offered universal and immediate ART (intervention clusters) or according to national guidelines (control clusters). Entry into care was defined as attending a TasP clinic within three months of referral among adults not actively in HIV care (no visit to local HIV programme within past 13 months). Associated factors were identified separately by sex, using multivariable logistic regression. Results: Overall, 1,205 adults (72.6% women) not actively in HIV care were referred to a TasP clinic. Of these, 405 (33.6%) attended a TasP clinic within three months (no difference between trial arms): 32.5% of women, 36.7% of men. Participants who ever visited the local HIV programme (n=360) were more likely to enter into care than those who didn''t (women: adjusted Odd-Ratio (aOR) 1.76, 95% Confidence Interval [1.26-2.45]; men: 2.07 [1.18-3.64]). In women (n=875), those less likely to attend a TasP clinic within three months had completed some secondary school (0.51 [0.33-0.79]) or at least secondary school (0.47 [0.29-0.76]) versus below primary school; were living 1-2 km from a TasP clinic (0.43 [0.30-0.62]) or 2-5 km (0.40 [0.27-0.61]) versus < 1 km; didn''t know anyone HIV+ within their family (0.60 [0.43-0.81]) and didn''t agree that it is good to initiate ART as soon as possible if infected (0.47 [0.26-0.85]); among men (n=330), none of the factors examined was significantly associated…
presented at: 8th IAS Conference on HIV Pathogeneis, Treatment & Prevention
date: 2015-07-22
citation key: plazyEntryCareFollowing2015
description: 00000