Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa.
Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa.
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DOI：
10.1371/journal.pone.0013801
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发表时间：
2010-11-02
期刊：
影响因子：
3.7
通讯作者：
Wood R
中科院分区：
文献类型：
--
作者：
Kranzer K;Zeinecker J;Ginsberg P;Orrell C;Kalawe NN;Lawn SD;Bekker LG;Wood R
抗逆转录病毒疗法(ART)在非洲迅速扩大。方案报告通常集中在接受抗逆转录病毒治疗的患者中失去随访和死亡率。然而，在开始抗逆转录病毒治疗之前，人们对个体之间的联系和保留知之甚少。来自开普敦郊区社区的成年居民的数据是在一家初级保健诊所和医院收集的。将艾滋病毒检测登记册、国家卫生实验室系统提供的CD4计数结果和抗逆转录病毒治疗登记册联系起来。从2004年1月至2009年3月期间通过产前检查、性传播疾病以及自愿检测和咨询服务检测出艾滋病毒阳性的成年人中随机抽取样本(n = 885)。所有在同一时期通过结核病服务检测出艾滋病毒阳性的成年人(n = 103)也包括在这项研究中。与艾滋病毒护理的联系被定义为在艾滋病毒诊断后6个月内参加CD4计数测量。与抗逆转录病毒治疗的联系被定义为在艾滋病毒确诊后6个月内开始抗逆转录病毒治疗，患者的CD4细胞计数≤为200个/µL，在艾滋病毒确诊后6个月内采集。只有62.6%的人在检测出HIV阳性后的6个月内参加了CD4计数测量。通过性传播感染服务进行检测的个人最好(84.1%)，主动检测的个人(53.5%)与艾滋病毒护理的联系最差。及时进行CD4计数的人中有三分之一有资格接受抗逆转录病毒治疗，其中66.7%的人成功地与抗逆转录病毒治疗联系在一起。与ART护理的联系在产前护理客户中最高。在还没有资格接受抗逆转录病毒治疗的人中，只有46.3%的人有重复的CD4计数。在较近的日历期间测试的患者中，与艾滋病毒护理的联系有所改善。在这个贫穷的城市周边社区，艾滋病毒和艺术护理的联系很低，尽管在很近的地方可以提供免费服务。需要更多的努力来将VCT规模扩大与后续护理联系起来。
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. 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. 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. 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.
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影响因子：
15.8
作者：
Mills EJ;Nachega JB;Bangsberg DR;Singh S;Rachlis B;Wu P;Wilson K;Buchan I;Gill CJ;Cooper C
通讯作者：
Cooper C
影响因子：
5.7
作者：
Lawn SD;Kranzer K;Wood R
通讯作者：
Wood R
DOI：
10.2471/blt.07.044248
发表时间：
2008-07-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Brinkhof, Martin WG;Dabis, François;Anglaret, Xavier
通讯作者：
Anglaret, Xavier
DOI：
10.1016/j.trstmh.2008.10.001
发表时间：
2009-06-01
影响因子：
2.2
作者：
MacPherson, Peter;Moshabela, Mosa;Pronyk, Paul
通讯作者：
Pronyk, Paul
性别和收入对南非抗逆转录病毒疗法计划中生存和保留的影响。
DOI：
10.1111/j.1365-3156.2009.02290.x
发表时间：
2009-07
期刊：
Tropical medicine & international health : TM & IH
影响因子：
--
作者：
Cornell M;Myer L;Kaplan R;Bekker LG;Wood R
通讯作者：
Wood R