ArticleJournal of acquired immune deficiency syndromes (1999)2016
Attrition and Opportunities Along the HIV Care Continuum: Findings From a Population-Based Sample, North West Province, South Africa.
Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis.Journal of the International AIDS Society · 2022Pooled it
- Interventions to improve antiretroviral adherence in HIV-infected pregnant women: A systematic review and meta-analysis.Frontiers in public health · 2022Pooled it
- The HIV care cascade in sub-Saharan Africa: systematic review of published criteria and definitions.Journal of the International AIDS Society · 2021Pooled it
- Strategies for retention of heterosexual men in HIV care in sub-Saharan Africa: A systematic review.PloS one · 2021Pooled it
- Evaluation of the Tsima community mobilization intervention to improve engagement in HIV testing and care in South Africa: study protocol for a cluster randomized trial.Implementation science : IS · 2017Trial
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- Article
- The prevalence, incidence, and sociodemographic risk factors of HIV among older adults in sub-Saharan Africa (AWI-Gen): a multicentre, longitudinal cohort study.The lancet. Healthy longevity · 2025Article
- Process evaluation of the 'Lafiyan Yara' project on enhancing access to HIV testing services using existing community structures in Nigeria.BMC public health · 2024Article
- Statistical methods applied for the assessment of the HIV cascade and continuum of care: a systematic scoping review.BMJ open · 2023Article
- Article
- Gender, Mental Health, and Entry Into Care with Advanced HIV Among People Living with HIV in Cameroon Under a National 'Treat All' Policy.AIDS and behavior · 2021Article
- Health Care Providers' Challenges to High-Quality HIV Care and Antiretroviral Treatment Retention in Rural South Africa.Qualitative health research · 2021Article
- Quantifying the gender gap in the HIV care cascade in southern Mozambique: We are missing the men.PloS one · 2021Article
- Predictors of antiretroviral therapy initiation in eThekwini (Durban), South Africa: Findings from a prospective cohort study.PloS one · 2021Article
- HIV treatment cascade for older adults in rural South Africa.Sexually transmitted infections · 2020Article
- The role of drug resistance in poor viral suppression in rural South Africa: findings from a population-based study.BMC infectious diseases · 2020Article
- Improvements in the South African HIV care cascade: findings on 90-90-90 targets from successive population-representative surveys in North West Province.Journal of the International AIDS Society · 2019Article
- Beyond Social Desirability Bias: Investigating Inconsistencies in Self-Reported HIV Testing and Treatment Behaviors Among HIV-Positive Adults in North West Province, South Africa.AIDS and behavior · 2018Article
- Context matters: Community social cohesion and health behaviors in two South African areas.Health & place · 2018Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundAttrition along the HIV care continuum slows gains in mitigating the South African HIV epidemic. Understanding population-level gaps in HIV identification, linkage, retention in care, and viral suppression is critical to target programming.
methodsWe conducted a population-based household survey, HIV rapid testing, point-of-care CD4 testing, and viral load measurement from dried blood spots using multistage cluster sampling in 2 subdistricts of North West Province from January to March, 2014. We used weighting and multiple imputation of missing data to estimate HIV prevalence, undiagnosed infection, linkage and retention in care, medication adherence, and viral suppression.
resultsWe sampled 1044 respondents aged 18-49. HIV prevalence was 20.0% (95% confidence interval: 13.7 to 26.2) for men and 26.7% (95% confidence interval: 22.1 to 31.4) for women. Among those HIV positive, 48.4% of men and 75.7% of women were aware of their serostatus; 44.0% of men and 74.8% of women reported ever linking to HIV care; 33.1% of men and 58.4% of women were retained in care; and 21.6% of men and 50.0% of women had dried blood spots viral loads <5000 copies per milliliter. Among those already linked to care, 81.7% on antiretroviral treatment (ART) and 56.0% of those not on ART were retained in care, and 51.8% currently retained in care on ART had viral loads <5000 copies per milliliter.
conclusionsDespite expanded treatment in South Africa, attrition along the continuum of HIV care is slowing prevention progress. Improved detection is critically needed, particularly among men. Reported linkage and retention is reasonable for those on ART; however, failure to achieve viral suppression is worrisome.
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