Same-Day CD4 Testing to Improve Uptake of HIV Care and Treatment in South Africa: Point-of-Care Is Not EnoughReportar como inadecuado




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AIDS Research and TreatmentVolume 2013 2013, Article ID 941493, 7 pages

Clinical Study

Boston University Center for Global Health and Development, Boston University, Boston, MA 02118, USA

Department of International Health, Boston University School of Public Health, Boston University, Boston, MA 02118, USA

Health Economics and Epidemiology Research Office, Department of Clinical Medicine, School of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2198, South Africa

Right to Care, Johannesburg 2041, South Africa

United States Agency for International Development, South Africa Mission, Pretoria 0027, South Africa

Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, MA 02118, USA

Received 4 April 2013; Revised 5 June 2013; Accepted 10 June 2013

Academic Editor: Glenda Gray

Copyright © 2013 Bruce A. Larson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. We evaluated whether a pilot program providing point-of-care POC, but not rapid, CD4 testing BD FACSCount immediately after testing HIV-positive improved retention in care. Methods. We conducted a retrospective record review at the Themba Lethu Clinic in Johannesburg, South Africa. We compared all walk-in patients testing HIV-positive during February, July 2010 pilot POC period to patients testing positive during January 2008–February 2009 baseline period. The outcome for those with a cells-mm

when testing HIV-positive was initiating ART weeks after HIV testing. Results. 771 patients had CD4 results from the day of HIV testing 421 pilots, 350 baselines. ART initiation within 16 weeks was 49% in the pilot period and 46% in the baseline period. While all 421 patients during the pilot period should have been offered the POC test, patient records indicate that only 73% of them were actually offered it, and among these patients only 63% accepted the offer. Conclusions. Offering CD4 testing using a point-of-care, but not rapid, technology and without other health system changes had minor impacts on the uptake of HIV care and treatment. Point-of-care technologies alone may not be enough to improve linkage to care and treatment after HIV testing.





Autor: Bruce A. Larson, Kathryn Schnippel, Alana Brennan, Lawrence Long, Thembi Xulu, Thapelo Maotoe, Sydney Rosen, Ian Sanne, an

Fuente: https://www.hindawi.com/



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