ArticleJournal of the International AIDS Society2020
Delays in repeat HIV viral load testing for those with elevated viral loads: a national perspective from South Africa.
Article in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 25 citations in OpenAlex.
- Do Adolescents Living With HIV in Kenya Know Their Viral Load Results? Record Audit and Adolescent Exit Surveys in Kiambu and Nakuru Counties: A Cross-Sectional Study.The Journal of the Association of Nurses in AIDS Care : JANAC · 2025Article
- Record linkage without patient identifiers: Proof of concept using data from South Africa's national HIV program.PLOS global public health · 2025Article
- Article
- Attrition Rates in HIV Viral Load Monitoring and Factors Associated With Overdue Testing Among Children Within South Africa's Antiretroviral Treatment Program: Retrospective Descriptive Analysis.JMIR public health and surveillance · 2024Article
- Compliance to Viral Load Monitoring Schedules Among Women Attending Prevention of Vertical HIV Transmission Services Before and During the COVID-19 Pandemic in Ehlanzeni District, Mpumalanga, South Africa.AIDS and behavior · 2024Article
- Enriching Data Science and Health Care Education: Application and Impact of Synthetic Data Sets Through the Health Gym Project.JMIR medical education · 2024Article
- The fall-And rise-In hospital-based care for people with HIV in South Africa: 2004-2017.PLOS global public health · 2024Article
- Clinical Outcomes After Viremia Among People Receiving Dolutegravir vs Efavirenz-Based First-line Antiretroviral Therapy in South Africa.Open forum infectious diseases · 2023Article
- Strengthening HIV and HIV co-morbidity care in low- and middle-income countries: insights from behavioural economics to improve healthcare worker behaviour.Journal of the International AIDS Society · 2023Article
- Cohort profile: the South African National Health Laboratory Service (NHLS) National HIV Cohort.BMJ open · 2022Article
- Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study.BMC public health · 2022Article
- Article
- Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa.African journal of laboratory medicine · 2022Article
- Unsuppressed viral load after intensive adherence counselling in rural eastern Uganda; a case of Kamuli district, Uganda.BMC public health · 2021Article
- Acquired HIV drug resistance and virologic monitoring in a HIV hyper-endemic setting in KwaZulu-Natal Province, South Africa.AIDS research and therapy · 2021Article
- Coverage of maternal viral load monitoring during pregnancy in South Africa: Results from the 2019 national Antenatal HIV Sentinel Survey.HIV medicine · 2021Article
- Article
- Evaluation of near point-of-care viral load implementation in public health facilities across seven countries in sub-Saharan Africa.Journal of the International AIDS Society · 2021Article
- Delays in repeat HIV viral load testing for those with elevated viral loads: a national perspective from South Africa.Journal of the International AIDS Society · 2020Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionIn South Africa, HIV patients with an elevated viral load (VL) should receive repeat VL testing after adherence counselling. We set out to use a national HIV Cohort to describe time to repeat viral load testing across South Africa and identify predictors of time to repeat testing.
methodsWe conducted a cohort study of prospectively collected laboratory data. HIV treatment guidelines have changed over time in South Africa, but call for repeat VL testing within six months if 400 to 1000 copies/mL and two to three months if >1000 copies/mL. We included patients with suppressed viral loads (indicating they are on ART) and a first elevated VL (>400 copies/mL) between April 2004 and December 2014. Follow-up began at first elevated VL and continued until repeat testing, loss to follow-up or December 2016. We calculated adjusted hazard ratios (aHR) using Cox proportional hazard models.
resultsOf 371,648 patients with a VL > 400, 83.9% (311,790) had a repeat VL, in a median (IQR) of 7.0 (4.1 to 12.2) months. Of those with a first viral load 400 to 1000 copies/mL, 56.4% had a repeat VL within guideline recommended six months (defined as up to nine months), whereas among those >1000 copies/mL only 47.7% had a repeat viral load within guideline recommended two to three months (defined as up to six months). We found a small increase in repeat testing associated with higher VL value (aHR 1.11; 95% CI: 1.10 to 1.12 comparing >1000 vs 400 to 1000 copies/mL) and very low CD4 counts at first elevated VL (aHR 1.16; 95% CI: 1.13 to 1.19 comparing CD4 < 50 vs <500 cells/mm
conclusionsMedian time to repeat viral load testing for those with an elevated viral load was longer than guidelines recommend. Future work should identify whether delays are due to patient or provider factors.
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