Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa

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dc.contributor.authorKranzer, Katharinaen_ZA
dc.contributor.authorZeinecker, Jenniferen_ZA
dc.contributor.authorGinsberg, Philipen_ZA
dc.contributor.authorOrrell, Catherineen_ZA
dc.contributor.authorKalawe, Nosindiso Nen_ZA
dc.contributor.authorLawn, Stephen Den_ZA
dc.contributor.authorBekker, Linda-Gailen_ZA
dc.contributor.authorWood, Robinen_ZA
dc.date.accessioned2015-11-23T12:25:44Z
dc.date.available2015-11-23T12:25:44Z
dc.date.issued2010en_ZA
dc.description.abstractBACKGROUND: Antiretroviral therapy (ART) has been scaled-up rapidly in Africa. Programme reports typically focus on loss to follow-up and mortality among patients receiving ART. However, little is known about linkage and retention in care of individuals prior to starting ART. METHODOLOGY: Data on adult residents from a periurban community in Cape Town were collected at a primary care clinic and hospital. HIV testing registers, CD4 count results provided by the National Health Laboratory System and ART registers were linked. A random sample (n = 885) was drawn from adults testing HIV positive through antenatal care, sexual transmitted disease and voluntary testing and counseling services between January 2004 and March 2009. All adults (n = 103) testing HIV positive through TB services during the same time period were also included in the study. Linkage to HIV care was defined as attending for a CD4 count measurement within 6 months of HIV diagnosis. Linkage to ART care was defined as initiating ART within 6 months of HIV diagnosis in individuals with a CD4 count ≤200 cells/µl taken within 6 months of HIV diagnosis. FINDINGS: Only 62.6% of individuals attended for a CD4 count measurement within 6 months of testing HIV positive. Individuals testing through sexually transmitted infection services had the best (84.1%) and individuals testing on their own initiative (53.5%) the worst linkage to HIV care. One third of individuals with timely CD4 counts were eligible for ART and 66.7% of those were successfully linked to ART care. Linkage to ART care was highest among antenatal care clients. Among individuals not yet eligible for ART only 46.3% had a repeat CD4 count. Linkage to HIV care improved in patients tested in more recent calendar period. CONCLUSION: Linkage to HIV and ART care was low in this poor peri-urban community despite free services available within close proximity. More efforts are needed to link VCT scale-up to subsequent care.en_ZA
dc.identifier.apacitationKranzer, K., Zeinecker, J., Ginsberg, P., Orrell, C., Kalawe, N. N., Lawn, S. D., ... Wood, R. (2010). Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa. <i>PLoS One</i>, http://hdl.handle.net/11427/15282en_ZA
dc.identifier.chicagocitationKranzer, Katharina, Jennifer Zeinecker, Philip Ginsberg, Catherine Orrell, Nosindiso N Kalawe, Stephen D Lawn, Linda-Gail Bekker, and Robin Wood "Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa." <i>PLoS One</i> (2010) http://hdl.handle.net/11427/15282en_ZA
dc.identifier.citationKranzer, K., Zeinecker, J., Ginsberg, P., Orrell, C., Kalawe, N. N., Lawn, S. D., ... & Wood, R. (2010). Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa. PloS one, 5(11), e13801. doi:10.1371/journal.pone.0013801en_ZA
dc.identifier.ris TY - Journal Article AU - Kranzer, Katharina AU - Zeinecker, Jennifer AU - Ginsberg, Philip AU - Orrell, Catherine AU - Kalawe, Nosindiso N AU - Lawn, Stephen D AU - Bekker, Linda-Gail AU - Wood, Robin AB - BACKGROUND: Antiretroviral therapy (ART) has been scaled-up rapidly in Africa. Programme reports typically focus on loss to follow-up and mortality among patients receiving ART. However, little is known about linkage and retention in care of individuals prior to starting ART. METHODOLOGY: Data on adult residents from a periurban community in Cape Town were collected at a primary care clinic and hospital. HIV testing registers, CD4 count results provided by the National Health Laboratory System and ART registers were linked. A random sample (n = 885) was drawn from adults testing HIV positive through antenatal care, sexual transmitted disease and voluntary testing and counseling services between January 2004 and March 2009. All adults (n = 103) testing HIV positive through TB services during the same time period were also included in the study. Linkage to HIV care was defined as attending for a CD4 count measurement within 6 months of HIV diagnosis. Linkage to ART care was defined as initiating ART within 6 months of HIV diagnosis in individuals with a CD4 count ≤200 cells/µl taken within 6 months of HIV diagnosis. FINDINGS: Only 62.6% of individuals attended for a CD4 count measurement within 6 months of testing HIV positive. Individuals testing through sexually transmitted infection services had the best (84.1%) and individuals testing on their own initiative (53.5%) the worst linkage to HIV care. One third of individuals with timely CD4 counts were eligible for ART and 66.7% of those were successfully linked to ART care. Linkage to ART care was highest among antenatal care clients. Among individuals not yet eligible for ART only 46.3% had a repeat CD4 count. Linkage to HIV care improved in patients tested in more recent calendar period. CONCLUSION: Linkage to HIV and ART care was low in this poor peri-urban community despite free services available within close proximity. More efforts are needed to link VCT scale-up to subsequent care. DA - 2010 DB - OpenUCT DO - 10.1371/journal.pone.0013801 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa TI - Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa UR - http://hdl.handle.net/11427/15282 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15282
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0013801
dc.identifier.vancouvercitationKranzer K, Zeinecker J, Ginsberg P, Orrell C, Kalawe NN, Lawn SD, et al. Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa. PLoS One. 2010; http://hdl.handle.net/11427/15282.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2010 Kranzer et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherHIV diagnosis and managementen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherAntenatal careen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherTotal cell countingen_ZA
dc.subject.otherPrimary careen_ZA
dc.titleLinkage to HIV care and antiretroviral therapy in Cape Town, South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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