Abstract
BackgroundFew studies have evaluated access to and retention in pre-ART care.ObjectivesTo evaluate the proportion of People Living With HIV (PLWH) in pre-ART and ART care and factors associated with retention in pre-ART and ART care from a community cohort.MethodsA cross sectional survey was conducted from February – April 2011. Self reported HIV positive, negative or participants of unknown status completed a questionnaire on their HIV testing history, access to pre-ART and retention in pre-ART and ART care.Results872 randomly selected adults who reported being HIV positive in the ZAMSTAR 2010 prevalence survey were included and revisited. 579 (66%) reconfirmed their positive status and were included in this analysis. 380 (66%) had initiated ART with 357 of these (94%) retained in ART care. 199 (34%) had never initiated ART of whom 186 (93%) accessed pre-ART care, and 86 (43%) were retained in pre-ART care. In a univariable analysis none of the factors analysed were significantly associated with retention in care in the pre-ART group. Due to the high retention in ART care, factors associated with retention in ART care, were not analysed further.ConclusionRetention in ART care was high; however it was low in pre-ART care. The opportunity exists, if care is better integrated, to engage with clients in primary health care facilities to bring them back to, and retain them in, pre-ART care.
Highlights
South Africa had an estimated HIV incidence of 0.94% in adults in 2012 [1] with an estimated 6.1 million people living with HIV (PLWH) of which 2.2 million were on antiretroviral therapy (ART) [2]
Retention in ART care was high; it was low in pre-ART care
There has been a strong drive to increase the numbers of people testing for HIV and HIV counselling and testing (HCT) occurs at all levels of the health care system, and within different health care programmes such as the Prevention of Mother to Child Transmission (PMTCT) programme and the Tuberculosis (TB) programme
Summary
South Africa had an estimated HIV incidence of 0.94% in adults in 2012 [1] with an estimated 6.1 million people living with HIV (PLWH) of which 2.2 million were on antiretroviral therapy (ART) [2]. There has been a strong drive to increase the numbers of people testing for HIV and HIV counselling and testing (HCT) occurs at all levels of the health care system, and within different health care programmes such as the Prevention of Mother to Child Transmission (PMTCT) programme and the Tuberculosis (TB) programme. It is offered at community sites, through outreach drives and at the work place. Studies in South Africa show that the majority of persons who initiate ART have low CD4 cell counts [3,4]. Few studies have evaluated access to and retention in pre-ART care
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