@article{fdi:010068700,
  title = {{F}actors associated with {HIV} status awareness and linkage to care following home based testing in rural {M}alawi},
  author = {{M}aman, {D}. and {B}en-{F}arhat, {J}. and {C}hilima, {B}. and {M}asiku, {C}. and {S}alumu, {L}. and {F}ord, {N}. and {M}endiharat, {P}. and {S}zumilin, {E}. and {M}asson, {S}. and {E}tard, {J}ean-{F}ran{\c{c}}ois},
  editor = {},
  language = {{ENG}},
  abstract = {{OBJECTIVE} {HIV} diagnosis and linkage to care are the main barriers in {A}frica to achieving the {UNAIDS} 90-90-90 targets. {W}e assessed {HIV}-positive status awareness and linkage to care among survey participants in {C}hiradzulu {D}istrict, {M}alawi. {METHOD} {N}ested cohort study within a population-based survey of persons aged 15-59 years between {F}ebruary and {M}ay 2013. {P}articipants were interviewed and tested for {HIV} (and {CD}4 if found {HIV}-positive) in their homes. {M}ultivariable regression was used to determine factors associated with {HIV}-positive status awareness prior to the survey and subsequent linkage to care. {RESULTS} {O}f 8277 individuals eligible for the survey, 7270 (87.8%) participated and were tested for {HIV}. {T}he overall {HIV} prevalence was 17.0%. {A}mong {HIV}-positive participants, 77.0% knew their status and 72.8% were in care. {W}omen (adjusted odds ratio [a{OR}] 6.5, 95% {CI} 3.2-13.1) and older participants (40-59 vs. 15-29 years, a{OR} 10.1, 95% {CI} 4.0-25.9) were more likely to be aware of their positive status. {O}f those newly diagnosed, 47.5% were linked to care within 3 months. {L}inkage to care was higher among older participants (40-59 vs. 15-29, adjusted hazard ratio [a{HR}] 3.39, 95% {CI} 1.83-6.26), women (a{HR} 1.73, 95% {CI} 1.12-2.67) and those eligible for {ART} (a{HR} 1.61, 95% {CI} 1.03-2.52). {CONCLUSIONS} {I}n settings with high levels of {HIV} awareness, home-based testing remains an efficient strategy to diagnose and link to care. {M}en were less likely to be diagnosed, and when diagnosed to link to care, underscoring the need for a gender focus in order to achieve the 90-90-90 targets.},
  keywords = {linkage to care ; population survey ; sub-{S}aharan {A}frica ; cascade of care ; epidemiology ; {MALAWI} ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{T}ropical {M}edicine and {I}nternational {H}ealth},
  volume = {21},
  numero = {11},
  pages = {1442--1451},
  ISSN = {1360-2276},
  year = {2016},
  DOI = {10.1111/tmi.12772},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068700},
}