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PLoS One. 2014 May 7;9(5):e96867. doi: 10.1371/journal.pone.0096867. eCollection 2014.

Missed opportunities for retention in pre-ART care in Cape Town, South Africa.

Author information

1
Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Stellenbosch University, Parow, South Africa.
2
The South African Department of Science and Technology/National Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa.
3
City of Cape Town Health Directorate, Cape Town, South Africa.
4
School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.

Abstract

BACKGROUND:

Few studies have evaluated access to and retention in pre-ART care.

OBJECTIVES:

To evaluate the proportion of People Living With HIV (PLWH) in pre-ART and ART care and factors associated with retention in pre-ART and ART care from a community cohort.

METHODS:

A cross sectional survey was conducted from February - April 2011. Self reported HIV positive, negative or participants of unknown status completed a questionnaire on their HIV testing history, access to pre-ART and retention in pre-ART and ART care.

RESULTS:

872 randomly selected adults who reported being HIV positive in the ZAMSTAR 2010 prevalence survey were included and revisited. 579 (66%) reconfirmed their positive status and were included in this analysis. 380 (66%) had initiated ART with 357 of these (94%) retained in ART care. 199 (34%) had never initiated ART of whom 186 (93%) accessed pre-ART care, and 86 (43%) were retained in pre-ART care. In a univariable analysis none of the factors analysed were significantly associated with retention in care in the pre-ART group. Due to the high retention in ART care, factors associated with retention in ART care, were not analysed further.

CONCLUSION:

Retention in ART care was high; however it was low in pre-ART care. The opportunity exists, if care is better integrated, to engage with clients in primary health care facilities to bring them back to, and retain them in, pre-ART care.

PMID:
24806474
PMCID:
PMC4013078
DOI:
10.1371/journal.pone.0096867
[Indexed for MEDLINE]
Free PMC Article
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