Testing modality associated with fast-track ART initiation in Botswana.

Autor: Lavoie MC; Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA., Blanco N; Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA., Keapoletswe K; Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana., Marima R; Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana., Ntwayagae OA; Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana., Sebina KB; Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana., Loeto P; Centers for Disease Control and Prevention, Gaborone, Botswana., Mogomotsi PG; Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana., Saleeb PG; Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA., Ndwapi N; Botswana-University of Maryland School of Medicine Health Initiative (Bummhi) Gaborone, Gaborone, Botswana., Stafford KA; Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2022 May; Vol. 27 (5), pp. 537-543. Date of Electronic Publication: 2022 Mar 23.
DOI: 10.1111/tmi.13745
Abstrakt: Objectives: The aim of this study was to identify community testing modalities associated with fast-track ART initiation in Botswana.
Methods: We conducted a retrospective cohort study that included all Botswana citizens 15 years or older who were newly identified as HIV-positive from 1 May 2017 to 31 January 2019, in Mahalapye and Southern districts. We used Poisson regression with robust error variance and generalised linear mixed models to control for cluster effects to model risk of ART initiation within 7 and 30 days of HIV diagnosis, testing modality factors.
Results: A total of 1436 individuals were newly identified HIV-positive, with men accounting for 60% across all testing modalities. 22% of all HIV-positive individuals were initiated on ART within 7 days. Clients diagnosed through index testing were more likely to be started on ART within 7 days (adjusted risk ratio [aRR] = 1.38, 95% CI 1.37-1.38) and 30 days (aRR = 1.17, 95% CI 1.09-1.26) than those diagnosed through mobile/outreach testing.
Conclusions: Community HIV testing can complement facility-based testing by reaching individuals who may be less likely to seek HIV services at a facility, such as men. Monitoring ART initiation by testing modalities is critical to identify the optimal ones and to guide continuous programme improvement.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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