ArticleAIDS (London, England)2017
Determinants of time from HIV infection to linkage-to-care in rural KwaZulu-Natal, South Africa.
Article in AIDS (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Improving Linkage to and Retention in Care in Newly Diagnosed HIV-Positive Patients Using Smartphones in South Africa: Randomized Controlled Trial.JMIR mHealth and uHealth · 2019Trial
- Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial.The Lancet. Global health · 2017Trial
- Epidemiological trends and burden of mortality from HIV/AIDS and multidrug-resistant tuberculosis without extensive drug-resistance across Africa: A global burden of disease analysis (1990-2021).Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- An enhanced cross-sectional HIV incidence estimator that incorporates prior HIV test results.Statistics in medicine · 2024Article
- Knowledge of HIV and/or AIDS and HIV testing services among young men in South Africa.African journal of primary health care & family medicine · 2023Article
- Universal HIV testing and the impact of late diagnosis on disease stage among adults in urban Ethiopia.Tropical medicine and health · 2023Article
- Built Environment and HIV Linkage to Care in Rural South Africa.Community health equity research & policy · 2023Article
- The geography of emergency department-based HIV testing in South Africa: Can patients link to care?EClinicalMedicine · 2021Article
- Usability and Clinical Performance Characteristics of the Asante HIV1/2 Test by Trained Users in Two African Sites.Diagnostics (Basel, Switzerland) · 2021Article
- Various structural factors influenced early antiretroviral therapy initiation amongst HIV infected prisoners: a qualitative exploration in South Ethiopia.BMC public health · 2021Article
- The effect of eligibility for antiretroviral therapy on body mass index and blood pressure in KwaZulu-Natal, South Africa.Scientific reports · 2021Article
- Overcoming Barriers to HIV Care: Findings from a Peer-Delivered, Community-Based, Linkage Case Management Program (CommLink), Eswatini, 2015-2018.AIDS and behavior · 2021Article
- Community-wide HIV testing, linkage case management, and defaulter tracing in Bukoba, Tanzania: pre-intervention and post-intervention, population-based survey evaluation.The lancet. HIV · 2020Article
- Towards achieving the 90-90-90 HIV targets: results from the south African 2017 national HIV survey.BMC public health · 2020Article
- Targeting the HIV Epidemic in South Africa: The Need for Testing and Linkage to Care in Emergency Departments.EClinicalMedicine · 2019Article
- A Patient-Centered Multicomponent Strategy for Accelerated Linkage to Care Following Community-Wide HIV Testing in Rural Uganda and Kenya.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Effect of a Patient-Centered Phone Call by a Clinical Officer at Time of HIV Testing on Linkage to Care in Rural Kenya.Open forum infectious diseases · 2018Article
- Article
- Changing Dynamics of HIV Transmission in Côte d'Ivoire: Modeling Who Acquired and Transmitted Infections and Estimating the Impact of Past HIV Interventions (1976-2015).Journal of acquired immune deficiency syndromes (1999) · 2017Article
- Population-level impact of an accelerated HIV response plan to reach the UNAIDS 90-90-90 target in Côte d'Ivoire: Insights from mathematical modeling.PLoS medicine · 2017Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo estimate time from HIV infection to linkage-to-care and its determinants. Linkage-to-care is usually assessed using the date of HIV diagnosis as the starting point for exposure time. However, timing of diagnosis is likely endogenous to linkage, leading to bias in linkage estimation.
designWe used longitudinal HIV serosurvey data from a large population-based HIV incidence cohort in KwaZulu-Natal (2004-2013) to estimate time of HIV infection. We linked these data to patient records from a public-sector HIV treatment and care program to determine time from infection to linkage (defined using the date of the first CD4 cell count).
methodsWe used Cox proportional hazards models to estimate time from infection to linkage and the effects of the following covariates on this time: sex, age, education, food security, socioeconomic status, area of residence, distance to clinics, knowledge of HIV status, and whether other household members have initiated antiretroviral therapy.
resultsWe estimated that it would take an average of 4.9 years for 50% of HIV seroconverters to be linked to care (95% confidence intervals: 4.2-5.7). Among all cohort members who were linked to care, the median CD4 cell count at linkage was 350 cells/μl (95% confidence interval: 330-380). Men and participants aged less than 30 years were found to have the slowest rates of linkage-to-care. Time to linkage became shorter over calendar time.
conclusionAverage time from HIV infection to linkage-to-care is long and needs to be reduced to ensure that HIV treatment-as-prevention policies are effective. Targeted interventions for men and young individuals have the largest potential to improve linkage rates.
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