Evidence map›Paper›PMID 30807481›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2019

A Patient-Centered Multicomponent Strategy for Accelerated Linkage to Care Following Community-Wide HIV Testing in Rural Uganda and Kenya.

James Ayieko, Maya L Petersen, Edwin D Charlebois, Lillian B Brown, Tamara D Clark, Dalsone Kwarisiima, Moses R Kamya, Craig R Cohen, Elizabeth A Bukusi, Diane V Havlir and 1 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01864603 (Sustainable East Africa Research in Community Health), which is not on this map. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01864603 nacompletednot on this map

Sustainable East Africa Research in Community Health

TypeinterventionalSponsorUniversity of California, San FranciscoRan2013 to 2021Enrolled150,395ConditionsHIV, Tuberculosis, Hypertension, DiabetesArmsUniversal ART in a streamlined care model, Annual Community Health Campaigns, Targeted PrEP and Targeted testing interventions, Baseline community-based HIV and multi-disease testing
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

James AyiekoCenter for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
Maya L PetersenDepartment of Biostatistics, School of Public Health, University of California, Berkeley, CA.
Edwin D CharleboisSchool of Medicine, University of California, San Francisco, CA.
Lillian B BrownSchool of Medicine, University of California, San Francisco, CA.
Tamara D ClarkSchool of Medicine, University of California, San Francisco, CA.
Dalsone KwarisiimaDepartment of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Moses R KamyaDepartment of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Craig R CohenSchool of Medicine, University of California, San Francisco, CA.
Elizabeth A BukusiCenter for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
Diane V HavlirSchool of Medicine, University of California, San Francisco, CA.
Annelies Van RieFaculty of Medicine and Public Health, University of Antwerp, Antwerp, Belgium.

Funding

Reducing Failure-to-Initiate ART: Streamlined ART Start Strategy (START)U01AI099959 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HAVLIR, DIANE V · 2012 to 2016
$39.7M
NIAID NIH HHS U01 AI099959PEPFAR
6 · The paper itself

Abstract

introductionAs countries move toward universal HIV treatment, many individuals fail to link to care after diagnosis of HIV. Efficient and effective linkage strategies are needed.

methodsWe implemented a patient-centered, multicomponent linkage strategy in the SEARCH "test-and-treat" trial (NCT 01864603) in Kenya and Uganda. After population-based, community-wide HIV testing, eligible participants were (1) introduced to clinic staff after testing, (2) provided a telephone "hot-line" for enquiries, (3) provided an appointment reminder phone call, (4) given transport reimbursement on linkage, and (5) tracked if linkage appointment was missed. We estimated the proportion linked to care within 1 year and evaluated factors associated with linkage at 7, 30, and 365 days after diagnosis.

resultsAmong 71,308 adults tested, 6811 (9.6%) were HIV-infected; of these, 4760 (69.9%) were already in HIV care, and 30.1% were not. Among 2051 not in care, 58% were female, median age was 32 (interquartile range 26-40) years, and median CD4 count was 493 (interquartile range 331-683) cells/µL. Half (49.7%) linked within 1 week, and 73.4% linked within 1 year. Individuals who were younger [15-34 vs. >35 years, adjusted Risk Ratio (aRR) 0.83, 95% confidence interval (CI): 0.74 to 0.94], tested at home vs. community campaign (aRR = 0.87, 95% CI: 0.81 to 0.94), had a high HIV-risk vs. low-risk occupation (aRR = 0.81, 95% CI: 0.75 to 0.88), and were wealthier (aRR 0.90, 95% CI: 0.83 to 0.97) were less likely to link. Linkage did not differ by marital status, stable residence, level of education, or having a phone contact.

conclusionsUsing a multicomponent linkage strategy, high proportions of people living with HIV but not in care linked rapidly after HIV testing.

Indexed as

AdultAnti-HIV AgentsFemaleHIV InfectionsHumansKenyaMaleMass ScreeningPatient Acceptance of Health CarePatient-Centered CareRural PopulationUgandaAnti-HIV Agents

Identifiers

PMID30807481
PMCPMC6410970

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.