Access to care in people living with HIV
Master Thesis
2012
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University of Cape Town
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Abstract
South Africa has the most people living with HIV (PLWH) in the world. With increased access to HIV Counselling and Testing (HCT) as well as expanded Antiretroviral Therapy (ART) treatment guidelines; there is a large and increasing number of people who need access to HIV care. Limited data and few studies have evaluated access to HIV care. A cross sectional survey with stratified random sampling was conductedfrom January – April 2011 to determine the proportion of PLWH in urban areas in thegreater Cape Town area who are accessing appropriate HIV care and factors associatedwith accessing care. The sampling frame for this study was the Zambia South Africa TBand AIDS Reduction (ZAMSTAR) Study. Self reported HIV positive adults were randomly selected. Self reported HIV negative adults or adults of unknown HIV status were also randomly selected in order to decrease possible stigmatisation. Consenting participants were interviewed and completed a questionnaire detailing their access to HIV testing and care. Participants who disclosed that they were HIV positive were included in the analysis. Access to appropriate HIV care was defined as one of three scenarios: 1. Receiving ART and having attended an ART clinic or collected ART medication within the last three months. 2. Undergoing ART work up and having attended an ART clinic within the last three months. 3. In PreART care having had a CD4 count in the last 6 months. 1257 participants were interviewed. 627(50%) reported being HIV positive, 487(39%) HIV negative and 143(11%) did not know or wish to disclose their status. Of the 627 HIV positive participants: 392 (63%) reported taking ART of whom 369 (94%) accessed appropriate HIV care. 25 (4 %) were being worked up for ART of whom 16 (64%) accessed appropriate HIV care. 210 (33%) were in PreART care, 81 (39%) having accessed appropriate HIV care. Females were 3.78 times more likely to be in appropriate care than males (p <0.001), and a person in the age category greater than 45 years was 4.63 times more likely to be in appropriate care than someone in the age category 15-24 (p= 0.002).
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Du Toit, E. 2012. Access to care in people living with HIV. University of Cape Town.