The “ART” of Linkage: Pre-Treatment Loss to Care after HIV Diagnosis at Two PEPFAR Sites in Durban, South Africa

• DOI: 10.1371/journal.pone.0009538
• Publication Date: 2010-03-03T17:50:48Z
• Authors: Elena Losina; Ingrid V. Bassett; Janet Giddy; Senica Chetty; Susan Regan; Rochelle P. Walensky; Douglas Ross; Callie A. Scott; Lauren M. Uhler; Jeffrey N. Katz; Helga Holst; Kenneth A. Freedberg
• Keywords: Adult; Male; Time Factors; Science; 610; HIV Infections; Research Subject Categories::MEDICINE::Microbiology; immunology; Cohort Studies; South Africa; 03 medical and health sciences; 0302 clinical medicine; 616; HIV Seropositivity; Humans; Prospective Studies; Demography; Geography; Q; R; Continuity of Patient Care; Middle Aged; Patient Acceptance of Health Care; 3. Good health; Treatment Outcome; Anti-Retroviral Agents; infectious diseases::Infectious diseases; Medicine; Patient Compliance; Female; Research Article

Although loss to follow-up after antiretroviral therapy (ART) initiation is increasingly recognized, little known about pre-treatment losses care (PTLC) an initial positive HIV test. Our objective was determine PTLC in newly identified HIV-infected individuals South Africa.We assembled the African Test, Identify and Link (STIAL) Cohort of persons presenting for testing at two sites offering CD4 count Durban, Africa. We defined as failure have a within 8 weeks diagnosis. performed multivariate analysis identify factors associated with PTLC. From November 2006 May 2007, 712 who underwent received their test result, 454 (64%) were HIV-positive. Of those, 206 (45%) had Infected patients significantly more likely if they lived > or = 10 kilometers from center (RR 1.37; 95% CI: 1.11-1.71), history tuberculosis treatment 1.26; 1.00-1.58), referred by health provider rather than self-referred 1.61; 1.22-2.13). Patients one, three these risks 1.88, 2.50 3.84 times compared those no risk factors.Nearly half high prevalence Africa, failed counts following These rates highlight urgent need improve linkage