ArticleAIDS (London, England)2014
Advanced disease at enrollment in HIV care in four sub-Saharan African countries: change from 2006 to 2011 and multilevel predictors in 2011.
Article in AIDS (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Outcomes of HIV-positive patients lost to follow-up in African treatment programmes.Tropical medicine & international health : TM & IH · 2017Pooled it
- Gender difference in advanced HIV disease and late presentation according to European consensus definitions.Scientific reports · 2015Pooled it
- Trends in CD4 count at presentation to care and treatment initiation in sub-Saharan Africa, 2002-2013: a meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Pooled it
- Frequency of HIV-testing and factors associated with multiple lifetime HIV-testing among a rural population of Zambian men.BMC public health · 2015Trial
- Article
- Outcomes After Being Lost to Follow-up Differ for Pregnant and Postpartum Women When Compared With the General HIV Treatment Population in Rural South Africa.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data.PloS one · 2020Article
- How to Evolve the Response to the Global HIV Epidemic With New Metrics and Targets Based on Pre-Treatment CD4 Counts.Current HIV/AIDS reports · 2019Review
- Article
- Treating all people living with HIV in sub-Saharan Africa: a new era calling for new approaches.Journal of virus eradication · 2018Article
- Mathematical modelling to inform 'treat all' implementation in sub-Saharan Africa: a scoping review.Journal of virus eradication · 2018Article
- Article
- Retention Throughout the HIV Care and Treatment Cascade: From Diagnosis to Antiretroviral Treatment of Adults and Children Living with HIV-Haiti, 1985-2015.The American journal of tropical medicine and hygiene · 2017Article
- Trends in one-year cumulative incidence of death between 2005 and 2013 among patients initiating antiretroviral therapy in Uganda.International journal of STD & AIDS · 2017Article
- Outcomes among HIV-infected children initiating HIV care and antiretroviral treatment in Ethiopia.Tropical medicine & international health : TM & IH · 2017Article
- Exploratory Analysis of Time from HIV Diagnosis to ART Start, Factors and effect on survival: A longitudinal follow up study at seven teaching hospitals in Ethiopia.Ethiopian journal of health sciences · 2017Article
- Population-level decline in BMI and systolic blood pressure following mass HIV treatment: Evidence from rural KwaZulu-Natal.Obesity (Silver Spring, Md.) · 2017Article
- Advanced Human Immunodeficiency Virus Disease at Diagnosis in Mozambique and Swaziland.Open forum infectious diseases · 2017Article
- Untangling the Relationship Between Antiretroviral Therapy Use and Incident Pregnancy: A Marginal Structural Model Analysis Using Data From 47,313 HIV-Positive Women in East Africa.Journal of acquired immune deficiency syndromes (1999) · 2016Observational
- Factors associated with initiation of antiretroviral therapy in the advanced stages of HIV infection in six Ethiopian HIV clinics, 2012 to 2013.Journal of the International AIDS Society · 2016Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
objectivesTo examine changes between 2006 and 2011 in the proportion of HIV-positive patients newly enrolled in HIV care with advanced disease and the median CD4 cell count at enrollment; and identify patient, facility, and contextual-level factors associated with late enrollment in care in 2011.
designCross-sectional over time.
methodsFor time-trends analyses, routinely collected patient-level data (307 110 adults newly enrolled in 138 HIV clinical care facilities) in Kenya, Mozambique, Rwanda and Tanzania; and for analyses of correlates, patient-level data (46 201 in 195 facilities), and facility and population-level survey data were used. Late enrollment was defined as CD4 cell count 350 cells/μl or less and/or WHO clinical stage 3/4.
resultsLate enrollment declined from 69.9 to 57.2% (P < 0.0001); median CD4 cell count increased from 242 to 292 cells/μl (Ptrend < 0.0001). In 2011, risk of late enrollment was significantly higher for men and nonpregnant women vs. pregnant women; patients aged above 25 vs. 15-25 years; nonmarried vs. married; and those entering from sites other than prevention of mother-to-child transmission. More extensive HIV testing coverage in the region of a facility was significantly associated with lower risk of late enrollment.
conclusionsDespite improvement, in 2011, 57% of patients entered HIV care who were already antiretroviral therapy-eligible. The lower risk of late enrollment among those referred from prevention of mother-to-child transmission and in regions where HIV testing coverage was higher suggests that innovative approaches to rapidly increase testing uptake among people living with HIV prior to the development of symptoms have the potential to reduce late enrollment in care.
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