The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Retention in care trajectories of HIV-positive individuals participating in a universal test and treat programme in rural South Africa (ANRS 12249 TasP trial)

Retention in care trajectories of HIV-positive individuals participating in a universal test and treat programme in rural South Africa (ANRS 12249 TasP trial)
Retention in care trajectories of HIV-positive individuals participating in a universal test and treat programme in rural South Africa (ANRS 12249 TasP trial)
Objective: To study retention in care (RIC) trajectories and associated factors in patients eligible for antiretroviral treatment (ART) in a universal test-and-treat setting (TasP trial, South Africa, 2012-2016). Design: A cluster-randomized trial whereby individuals identified HIV-positive after home-based testing were invited to initiate ART immediately (intervention) or following national guidelines (control). Methods: Exiting care was defined as ≥3 months late for a clinic appointment, transferring elsewhere, or death. Group-Based Trajectory Modelling was performed to estimate RIC trajectories over 18 months and associated factors in 777 ART-eligible patients. Results: Four RIC trajectory groups were identified: i) group 1 “remained” in care (reference, n=554, 71.3%), ii) group 2 exited care then “returned” after (median [interquartile range]) 4 [3-9] months (n=40, 5.2%), iii) group 3 “exited care rapidly” (after 4 [4-6] months, n=98, 12.6%), iv) group 4 “exited care later” (after 11 [9-13] months, n=85, 10.9%). Group 2 patients were less likely to have initiated ART within 1 month and more likely to be male, young (<29 years), without a regular partner and to have a CD4 count >350 cells/mm3. Group 3 patients were more likely to be women without social support, newly diagnosed, young, and less likely to have initiated ART within 1 month. Group 4 patients were more likely to be newly diagnosed and aged ≤39 years. Conclusions: High CD4 counts at care initiation were not associated with a higher risk of exiting care. Prompt ART initiation and special support for young and newly diagnosed HIV-patients are needed to maximize RIC.
1525-4135
375-385
Gosset, Andréa
ddda99a8-24ab-463e-8b87-131097db9857
Protopopescu, Camelia
3285bd04-8f67-4dad-95a9-7f27e398bf73
Larmarange, Joseph
8dc0592c-788f-4521-a3cb-4ff6c6aa06a3
Orne-Gliemann, Joanna
2124c323-6911-49d3-9e50-bddb35f521f8
Mcgrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Pillay, Deenan
9b4da6c6-2220-4c60-aaca-f0f1a37c2ca8
Dabis, Francois
d6d4dcd8-ae75-441d-b409-8730c5c25fc8
Iwuji, Collins
f5eddd38-8f66-420d-a6a3-9817f9dea287
Boyer, Sylvie
ac92cdf4-6029-44dd-8a57-11fea71b7077
Gosset, Andréa
ddda99a8-24ab-463e-8b87-131097db9857
Protopopescu, Camelia
3285bd04-8f67-4dad-95a9-7f27e398bf73
Larmarange, Joseph
8dc0592c-788f-4521-a3cb-4ff6c6aa06a3
Orne-Gliemann, Joanna
2124c323-6911-49d3-9e50-bddb35f521f8
Mcgrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Pillay, Deenan
9b4da6c6-2220-4c60-aaca-f0f1a37c2ca8
Dabis, Francois
d6d4dcd8-ae75-441d-b409-8730c5c25fc8
Iwuji, Collins
f5eddd38-8f66-420d-a6a3-9817f9dea287
Boyer, Sylvie
ac92cdf4-6029-44dd-8a57-11fea71b7077

Gosset, Andréa, Protopopescu, Camelia, Larmarange, Joseph, Orne-Gliemann, Joanna, Mcgrath, Nuala, Pillay, Deenan, Dabis, Francois, Iwuji, Collins and Boyer, Sylvie (2019) Retention in care trajectories of HIV-positive individuals participating in a universal test and treat programme in rural South Africa (ANRS 12249 TasP trial). JAIDS Journal of Acquired Immune Deficiency Syndromes, 80 (4), 375-385. (doi:10.1097/QAI.0000000000001938).

Record type: Article

Abstract

Objective: To study retention in care (RIC) trajectories and associated factors in patients eligible for antiretroviral treatment (ART) in a universal test-and-treat setting (TasP trial, South Africa, 2012-2016). Design: A cluster-randomized trial whereby individuals identified HIV-positive after home-based testing were invited to initiate ART immediately (intervention) or following national guidelines (control). Methods: Exiting care was defined as ≥3 months late for a clinic appointment, transferring elsewhere, or death. Group-Based Trajectory Modelling was performed to estimate RIC trajectories over 18 months and associated factors in 777 ART-eligible patients. Results: Four RIC trajectory groups were identified: i) group 1 “remained” in care (reference, n=554, 71.3%), ii) group 2 exited care then “returned” after (median [interquartile range]) 4 [3-9] months (n=40, 5.2%), iii) group 3 “exited care rapidly” (after 4 [4-6] months, n=98, 12.6%), iv) group 4 “exited care later” (after 11 [9-13] months, n=85, 10.9%). Group 2 patients were less likely to have initiated ART within 1 month and more likely to be male, young (<29 years), without a regular partner and to have a CD4 count >350 cells/mm3. Group 3 patients were more likely to be women without social support, newly diagnosed, young, and less likely to have initiated ART within 1 month. Group 4 patients were more likely to be newly diagnosed and aged ≤39 years. Conclusions: High CD4 counts at care initiation were not associated with a higher risk of exiting care. Prompt ART initiation and special support for young and newly diagnosed HIV-patients are needed to maximize RIC.

Text
Retention in care trajectories of HIV positive individuals participating in a universal test and treat programme in rural South Africa_ANRS 12249 TasP trial_23112018 - Accepted Manuscript
Download (2MB)

More information

In preparation date: 2018
Accepted/In Press date: 26 November 2018
Published date: 1 April 2019

Identifiers

Local EPrints ID: 426877
URI: http://eprints.soton.ac.uk/id/eprint/426877
ISSN: 1525-4135
PURE UUID: cc59e62b-ffcf-4132-a1aa-12ed650813b6
ORCID for Nuala Mcgrath: ORCID iD orcid.org/0000-0002-1039-0159

Catalogue record

Date deposited: 14 Dec 2018 17:30
Last modified: 22 Nov 2021 03:04

Export record

Altmetrics

Contributors

Author: Andréa Gosset
Author: Camelia Protopopescu
Author: Joseph Larmarange
Author: Joanna Orne-Gliemann
Author: Nuala Mcgrath ORCID iD
Author: Deenan Pillay
Author: Francois Dabis
Author: Collins Iwuji
Author: Sylvie Boyer

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×