Facility- and community-based efforts to improve human immunodeficiency virus (HIV) testing in sub-Saharan Africa may benefit from understanding how mental health influences HIV care-seeking behavior.

Introduction: Curable sexually transmitted infections (STIs) cause morbidity for women and increase HIV transmission acquisition. To address barriers to STI care, we are implementing testing integrated with prevention contraceptive services in hair salons urban South Africa. Methods: Women attending offered oral pre-exposure prophylaxis (PrEP), hormonal contraception, gonorrhea, chlamydia, trichomoniasis, syphilis within an ongoing pilot trial. Participants positive results treatment at the...

Background: There is an urgent need for more accurate screening tests tuberculosis (TB). We assessed the diagnostic accuracy of C-reactive protein (CRP) as a test active TB in HIV-infected ambulatory adults. Methods: CRP levels were measured blood collected at time HIV testing. Diagnostic pulmonary was calculated (reference standard: culture), compared to WHO 4-symptom screen, consisting cough, fever, night sweats, and weight loss. also larger cohort adults with positive symptom screen...

BackgroundSince mental health may influence HIV care among people living with (PLHIV), we sought to evaluate the impact of anxiety and depression on ART initiation HIV-related outcomes.MethodsWe conducted a prospective cohort study PLHIV in Umlazi Township KwaZulu-Natal, South Africa. We measured using Patient Health Questionnaire (PHQ-9) Generalized Anxiety Disorder (GAD-7) scale, both which have been validated sub-Saharan Africa, all patients prior receiving positive test. then followed...

We evaluated COVID-19 stigma and medical mistrust among people living with HIV in South Africa. conducted telephone interviews participants a prospective study of decentralized antiretroviral therapy program. Scales assessing mistrust, conspiracy beliefs, anticipated internalized stigma, stereotypes specific to were adapted primarily from the literature, higher scores indicating more or mistrust. Among 303 participants, median summary score was 4 [interquartile range (IQR) 0-8; possible...

Since rapid cryptococcal antigen lateral flow assays (CrAg LFA) may expedite treatment of HIV-associated infections, we sought to validate clinic-based CrAg LFA testing. Among newly-diagnosed HIV-infected adults in South Africa, a trained nurse performed testing urine, fingerprick capillary and venous whole blood with (Immy Diagnostics, Norman, USA). We matched laboratory-based serum an enzyme immunoassay (EIA). assessed diagnostic accuracy using EIA as the gold-standard, additional...

We assessed the impact of community- versus clinic-based medication pick-up on rates virologic suppression in an observational cohort adults ART enrolled a decentralized antiretroviral therapy program (CCMDD) South Africa. Participants either attended clinics where they were given choice to pick up community venues or traditional clinics, this pathway was assigned. Among 1856 participants, 977 (53%) opted for at enrollment, and 1201 (86%) virologically suppressed one year. Because missing...

South Africa's government-led Central Chronic Medication Dispensing and Distribution (CCMDD) program offers people living with HIV the option to collect antiretroviral therapy at their choice of community- or clinic-based pick-up points intended increase convenience decongest clinics. To understand CCMDD point use among HIV, we evaluated factors associated uptake a versus enrolment.

Community-based GeneXpert MTB/RIF testing may increase detection of prevalent TB in the community and improve rates treatment completion. We conducted a pilot randomized trial to evaluate impact screening on mobile HIV unit. Adults (≥18y) underwent rapid symptom were usual unit care (providing sputum sent out for testing) or "Test & Treat TB" intervention with immediate testing. Symptomatic participants produced that was hospital-based testing; contacted ~ 7 days later results. In...

Women experience challenges engaging with the healthcare system, but frequently utilize hair salons; these are promising venues for family planning and HIV prevention services. Our objective was to assess acceptability of nurse-offered contraceptive PrEP services at salons in Durban, South Africa. We interviewed salon owners (N = 10) clients 42) conducted focus groups stylists 43 stylists; 6 across five salons) explore barriers facilitators providing contraception salons. After developing a...

Abstract Background People living with HIV (PLHIV) may have concurrent Hepatitis B Virus (HBV) infection, and certain antiretroviral therapies are recommended for HBV-HIV co-infected individuals. Routine screening virus influence management of therapy PLHIV, but risk factors co-infection not been well defined. The objective this study was to identify HBV infection among PLHIV in South Africa. Methods We conducted a cross-sectional analysis prospective, clinic-based cohort adults seeking...

Introduction Young women are disproportionately affected by HIV in South Africa and have a high incidence of unintended pregnancies. Access to sexual reproductive health (SRH) services, including pre-exposure prophylaxis (PrEP), contraception screening for seally transmitted infections (STIs), remains limited Africa, part due inadequate infrastructure individual barriers care. Integrated, community-based SRH services the potential overcome clinic-based care at risk HIV, pregnancy STIs. We...

Cryptococcal antigen (CrAg) screening with fluconazole prophylaxis has been shown to prevent cryptococcal meningitis and mortality for people living HIV (PLWH) CD4 < 100 cells/mm3. While occurs in individuals 100-200 cells/mm3, there is limited evidence that CrAg predicts or among this group moderate immunosuppression. Current IDSA WHO clinical guidelines recommend restricting PLWH cells/mm3.We conducted a prospective cohort study of 18+ years who had not initiated ART South Africa. We...

Abstract Background Tuberculosis (TB)-related stigma presents a major barrier to care of persons with TB through its impact on treatment initiation and retention in care. This is particularly challenging settings high prevalence both HIV where fear HIV/AIDS can amplify surrounding TB. The purpose this study was validate scale for use among presenting outpatient screening the Umlazi township South Africa evaluate factors associated TB-related burden setting. Methods In cross-sectional study,...

Background Guidelines recommend integrating hypertension screening for HIV-infected adults, but blood pressure measurements may be dynamic around the time of HIV testing. Methods We measured a seated resting in adults (≥18 years) prior to testing, and again after receiving test results, an ambulatory clinic KwaZulu-Natal, South Africa. assessed sociodemographics, smoking, body mass index, diabetes, substance abuse, anxiety/depression. used categories defined by Seventh Joint National...

HIV stigma continues to act as a barrier care in South Africa, necessitating further research on the intersections of socioeconomic factors and anticipation expression surrounding HIV. We measured prevalence HIV-related evaluated associated with symbolic anticipated Umlazi Township, Africa from 2013 2019, using validated scale, before undergoing testing. Among 7,724 people evaluated, 1,318 (16.9%) reported 2,396 (30.8%) stigma. Prevalence were significantly more common among both women...

Abstract Timely uptake of Antiretroviral therapy considerably improves the health people living with Human Immunodeficiency virus. We conducted a cross-sectional study newly HIV diagnosed individuals in four clinics eThekwini municipality, KwaZulu-Natal. Data was collected between June 2020 and December 2020. Participants completed an interviewer-administered questionnaire after testing, on day diagnosis. evaluated factors influencing same-day ART initiation clinics, KwaZulu Natal, South...

Introduction: Cryptococcosis remains a leading cause of meningitis and mortality among people living with HIV (PLHIV) worldwide. We sought to evaluate laboratory-based cryptococcal antigen (CrAg) reflex testing clinic-based point-of-care (POC) CrAg screening intervention for preventing PLHIV in South Africa. Methods: conducted prospective pre–post study adults presenting Umlazi township, Africa, over 6-year period (2013–2019). Participants were enrolled during 3 phases testing: ordered by...

The COVID-19 pandemic and associated restrictions could adversely affect long-term HIV care. We evaluated the experiences of people receiving antiretroviral therapy (ART) through a decentralized delivery program in South Africa during pandemic. telephoned random subsample participants enrolled prospective cohort study KwaZulu-Natal April May 2020 administered semi-structured telephone interview to consenting participants. completed interviews with 303 638 contacted (47%); 66% were female,...

Abstract Background South Africa has not achieved the 90–90–90 goals, in part due to low rates of antiretroviral therapy (ART) initiation among those aware their HIV status. Perceived risk at time testing may affect likelihood rapid ART initiation. The purpose this study was evaluate factors associated with perceived and relationship between during universal test treat era which adapted October 2016. Methods We conducted a prospective adults undergoing from 2016–February 2019 Ithembalabantu...