Factors Associated With Poor Linkage to HIV Care in South Africa

摘要: © Copyright 2017 Wolters Kluwer Health, Inc. All rights reserved. Background: Poor linkage to HIV care is impeding achievement of the Joint United Nations Programme on and AIDS (UNAIDS) 90-90-90 targets. This study aims identify risk factors for poor linkage-to-care after counseling testing, thereby informing strategies achieve 90-90-90. Setting: The Thol'impilo trial was a large randomized controlled performed between 2012 2015 in South Africa, comparing different improve among adults aged ≥18 years who tested HIV-positive at mobile clinic testing. Methods: In this secondary analysis, sociodemographic associated with time were identified using Cox regression. Results: Of 2398 participants, 61% female, median age 33 (interquartile range: 27-41) CD4 count 427 cells/mm3 287-595). One thousand one hundred participants (46%) had verified within 365 days testing HIV-positive. adjusted younger [≤30 vs >40 years: hazard ratio (aHR): 0.58, 95% CI: 0.50 0.68; 31-40 aHR: 0.81, 0.70 0.94, test trend P < 0.001], being male (aHR: 0.86, 0.76 0.98, = 0.028), not African 0.79, 0.66 0.96, 0.014), urban district 0.82, 0.73 0.93, 0.002), employed 0.72 0.92, 0.001), nondisclosure 0.63, 0.56 0.72, having higher counts (test 0.001) all decreased linkage-to-care. Conclusion: Linkage-to-care low relatively cohort. Increasing requires innovative, evidence-based interventions particularly targeting individuals are younger, male, immigrant, urban, employed, reluctant disclose their status.