ArticleJournal of the International AIDS Society2016
Assessment of linkages from HIV testing to enrolment and retention in HIV care in Central Mozambique.
Article in Journal of the International AIDS Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Using routine health information data for research in low- and middle-income countries: a systematic review.BMC health services research · 2020Pooled it
- Barriers and facilitators to the uptake of Test and Treat in Mozambique: A qualitative study on patient and provider perceptions.PloS one · 2018Trial
- Article
- Improved detection and management of advanced HIV disease through a community adult TB-contact tracing intervention with same-day provision of the WHO-recommended package of care including ART initiation in a rural district of Mozambique.Journal of the International AIDS Society · 2021Article
- Patient-reported reasons for declining same-day antiretroviral therapy initiation in routine HIV care settings in Lusaka, Zambia: results from a mixed-effects regression analysis.Journal of the International AIDS Society · 2020Article
- Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique.PloS one · 2020Article
- Re-thinking Linkage to Care in the Era of Universal Test and Treat: Insights from Implementation and Behavioral Science for Achieving the Second 90.AIDS and behavior · 2019Article
- Tipping the balance towards long-term retention in the HIV care cascade: A mixed methods study in southern Mozambique.PloS one · 2019Article
- Article
- Continuum of HIV Care in Rural Mozambique: The Implications of HIV Testing Modality on Linkage and Retention.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Monitoring progress towards the first UNAIDS target: understanding the impact of people living with HIV who re-test during HIV-testing campaigns in rural Mozambique.Journal of the International AIDS Society · 2018Article
- Lessons learned and study results from HIVCore: an HIV implementation science initiative.Journal of the International AIDS Society · 2016Article
- Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.Journal of the International AIDS Society · 2016Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 2 countries.
Funding
Abstract
introductionEffectiveness of the rapid expansion of antiretroviral therapy (ART) throughout sub-Saharan Africa is highly dependent on adequate enrolment and retention in HIV care. However, the measurement of both has been challenging in these settings. This study aimed to assess enrolment and retention in HIV care (pre-ART and ART) among HIV-positive adults in Central Mozambique, including identification of barriers and facilitators.
methodsWe assessed linkages to and retention in HIV care using a mixed quantitative and qualitative approach in six districts of Manica and Sofala provinces. We analyzed routine district and health facility monthly reports and HIV care registries from April 2012 to March 2013 and used single imputation and trimmed means to adjust for missing values. In eight health facilities in the same districts and period, we assessed retention in HIV care among 795 randomly selected adult patient charts (15 years and older). We also conducted 25 focus group discussions and 53 in-depth interviews with HIV-positive adults, healthcare providers and community members to identify facilitators and barriers to enrolment and retention in HIV care.
resultsOverall, 46% of the monthly HIV testing reports expected at the district level were missing, compared to 6.4% of the pre-ART registry reports. After adjustment for missing values, we estimated that the aggregate numbers of adults registered in pre-ART was 75% of the number of persons tested HIV-positive in the six districts. In the eight health facilities, 40% of the patient charts for adults enrolled in pre-ART and 44% in ART were missing. Of those on ART for whom charts were found, retention in treatment within 90 and 60 days prior to the study team visit was 34 and 25%, respectively. Combining these multiple data sources, the overall estimated retention was 18% in our sample. Individual-level factors were perceived to be key influences to enrolment in HIV care, while health facility and structural-level factors were perceived to be key influences of retention.
conclusionsEfforts to increase linkages to and retention in HIV care should address individual, health facility, and structural-level factors in Central Mozambique. However, their outcomes cannot be reliably assessed without improving the quality of routine health information systems.
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