FIGTJJAL
type: UserItem
resource: From home-based HIV testing to viral suppression : HIV care trajectories in the context of Universal Test-and-Treat in rural South Africa
  type: Article
  abstract: Background : In order for people living with HIV to achieve an undetectable viral load, and thus live longer and healthier, they need access to a continuum of services. There are numerous reports of “leaks” at all steps of the HIV care cascade. We described the timing and sequencing of individual HIV care statuses from care referral to viral suppression, by identifying groups of individuals with similar trajectories and factors associated. Sample : We used prospective individual-level longitudinal data from the ANRS 12249 TasP cluster-randomized trial, which investigated the impact of universal antiretroviral treatment (ART) on HIV incidence in rural South Africa (2012-2016). We included trial participants >16 years, identified HIV+, not in care at referral and followed-up for ≥18 months. Method : The care status of all study participants was classified for each calendar day as : not in care, in care but not on ART, on ART but not virally suppressed, virally suppressed. We used state sequence data analysis to identify homogeneous care trajectories groups. A multinomial logistic regression was used to identify the profile of each group in terms of individual and cluster characteristics. Results : 1,816 participants were included. Median age was 34 years [IQR 27-45], 74% were female. We identified four care trajectories groups : (i) participants who mostly did not enter care (55%), (ii) participants with inconstant care, visiting a clinic occasionally but leaving care thereafter (median time to exit care : 10 m. [5.2-13]) (12%), (iii) participants who took extensive time at each step of the care continuum (median time between referral and ART : 8.0 m. [6.4-9.7]) (12%) and (iv) participants who rapidly progressed towards continuous care (median time between referral and ART : 1.2 m. [0.6-2.7]) (21%). Participants younger than 50 years, newly diagnosed at referral, living further than a kilometre from a trial clinic, and living in a cluster were immediate ART was not of…
  presented at: Life History Research Society Conference
  citation key: perriatHomebasedHIVTesting2018
  creator: Person
  author list: Person
  is part of: Proceedings
    publisher: communication orale
      type: Organization
      locality name: Paris
    date: 2018-05-31
rights: All rights reserved

Person
given name: Delphine
surname: Perriat

Person
given name: Mamadou Hassimiou
surname: Diallo

Person
given name: François
surname: Dabis

Person
given name: Deenan
surname: Pillay

Person
given name: Joanna
surname: Orne-Gliemann

Person
given name: Joseph
surname: Larmarange

Person
surname: ANRS 12249 TasP Study Group