ArticleGlobal health action2014
Determinants of the risk of dying of HIV/AIDS in a rural South African community over the period of the decentralised roll-out of antiretroviral therapy: a longitudinal study.
Article in Global health action, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Incidence and Predictors of Mortality Among Adults on Antiretroviral Therapy in Ethiopia: A Systematic Review and Meta-Analysis.Journal of epidemiology and global health · 2026Pooled it
- Accessibility of TB diagnostic services at primary healthcare clinics in the eThekwini district, South Africa: a geospatial analysis.BMJ open · 2024Article
- Healthcare provider perceptions on the implementation of the universal test-and-treat policy in South Africa: a qualitative inquiry.BMC health services research · 2023Article
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- Predictors of Survival Time Among HIV-Infected Adults After Initiating Anti-Retroviral Therapy in Kombolcha Town: A 5-Year Retrospective Cohort Study.HIV/AIDS (Auckland, N.Z.) · 2022Article
- Investigating clinic transfers among HIV patients considered lost to follow-up to improve understanding of the HIV care cascade: Findings from a cohort study in rural north-eastern South Africa.PLOS global public health · 2022Article
- Improving retention of community-recruited participants in HIV prevention research through Saturday household visits; findings from the HPTN 071 (PopART) study in South Africa.BMC medical research methodology · 2021Article
- Prevalence of Untreated HIV and Associated Risk Behaviors Among the Sexual Partners of Recent Migrants and Long-term Residents in Rakai, Uganda.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Article
- The impact of HIV status on the distance traveled to health facilities and adherence to care. A record-linkage study from rural South Africa.Journal of global health · 2020Article
- Migration, hotspots, and dispersal of HIV infection in Rakai, Uganda.Nature communications · 2020Article
- Article
- A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa.Global health action · 2019Article
- Risk Factors for Mortality among Adult HIV/AIDS Patients Following Antiretroviral Therapy in Southwestern Ethiopia: An Assessment through Survival Models.International journal of environmental research and public health · 2017Article
- CD4 Cell Count: Declining Value for Antiretroviral Therapy Eligibility.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Article
- Trends and determinants of survival for over 200 000 patients on antiretroviral treatment in the Botswana National Program: 2002-2013.AIDS (London, England) · 2016Article
- The development of a localised HIV epidemic and the associated excess mortality burden in a rural area of South Africa.Global health, epidemiology and genomics · 2016Article
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Authors and funding
9 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundAntiretroviral treatment (ART) has significantly reduced HIV mortality in South Africa. The benefits have not been experienced by all groups. Here we investigate the factors associated with these inequities.
designThis study was located in a rural South African setting and used data collected from 2007 to 2010, the period when decentralised ART became available. Approximately one-third of the population were of Mozambican origin. There was a pattern of repeated circular migration between urban areas and this community. Survival analysis models were developed to identify demographic, socioeconomic, and spatial risk factors for HIV mortality.
resultsAmong the study population of 105,149 individuals, there were 2,890 deaths. The HIV/TB mortality rate decreased by 27% between 2007-2008 and 2009-2010. For other causes of death, the reduction was 10%. Bivariate analysis found that the HIV/TB mortality risk was lower for: those living within 5 km of the Bhubezi Community Health Centre; women; young adults; in-migrants with a longer period of residence; permanent residents; and members of households owning motorised transport, holding higher socioeconomic positions, and with higher levels of education. Multivariate modelling showed, in addition, that those with South Africa as their country of origin had an increased risk of HIV/TB mortality compared to those with Mozambican origins. For males, those of South African origin, and recent in-migrants, the risk of death associated with HIV/TB was significantly greater than that due to other causes.
conclusionsIn this community, a combination of factors was associated with an increased risk of dying of HIV/TB over the period of the roll-out of ART. There is evidence for the presence of barriers to successful treatment for particular sub-groups in the population, which must be addressed if the recent improvements in population-level mortality are to be maintained.
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