@article{fdi:010067744,
  title = {{F}actors associated with antiretroviral treatment initiation amongst {HIV}-positive individuals linked to care within a universal test and treat programme : early findings of the {ANRS} 12249 {T}as{P} trial in rural {S}outh {A}frica},
  author = {{B}oyer, {S}. and {I}wuji, {C}. and {G}osset, {A}. and {P}rotopopescu, {C}. and {O}kesola, {N}. and {P}lazy, {M}. and {S}pire, {B}. and {O}rne-{G}liemann, {J}. and {M}c{G}rath, {N}. and {P}illay, {D}. and {D}abis, {F}. and {L}armarange, {J}oseph},
  editor = {},
  language = {{ENG}},
  abstract = {{P}rompt uptake of antiretroviral treatment ({ART}) is essential to ensure the success of universal test and treat ({UTT}) strategies to prevent {HIV} transmission in high-prevalence settings. {W}e describe {ART} initiation rates and associated factors within an ongoing {UTT} cluster-randomized trial in rural {S}outh {A}frica. {HIV}-positive individuals were offered immediate {ART} in the intervention arm vs. national guidelines recommended initiation ({CD}4350cells/mm(3)) in the control arm. {W}e used data collected up to {J}uly 2015 among the {ART}-eligible individuals linked to {T}as{P} clinics before {J}anuary 2015. {ART} initiation rates at one ({M}1), three ({M}3) and six months ({M}6) from baseline visit were described by cluster and {CD}4 count strata (cells/mm(3)) and other eligibility criteria: 100; 100-200; 200-350; {CD}4>350 with {WHO} stage 3/4 or pregnancy; {CD}4>350 without {WHO} stage 3/4 or pregnancy. {A} {C}ox model accounting for covariate effect changes over time was used to assess factors associated with {ART} initiation. {T}he 514 participants had a median [interquartile range] follow-up duration of 1.08 [0.69; 2.07] months until {ART} initiation or last visit. {ART} initiation rates at {M}1 varied substantially (36.9% in the group {CD}4>350 without {WHO} stage 3/4 or pregnancy, and 55.2-71.8% in the three groups with {CD}4350) but less at {M}6 (from 85.3% in the first group to 96.1-98.3% in the three other groups). {F}actors associated with lower {ART} initiation at {M}1 were a higher {CD}4 count and attending clinics with both high patient load and higher cluster {HIV} prevalence. {A}fter {M}1, having a regular partner was the only factor associated with higher likelihood of {ART} initiation. {T}hese findings suggest good {ART} uptake within a {UTT} setting, even among individuals with high {CD}4 count. {H}owever, inadequate staffing and healthcare professional practices could result in prioritizing {ART} initiation in patients with the lowest {CD}4 counts.},
  keywords = {{HIV} infection ; universal test and treat strategy ; early antiretroviral treatment ; {T}as{P} trial ; {S}outh {A}frica ; {AFRIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{A}ids {C}are : {P}sychological and {S}ocio-{M}edical {A}spects of {A}ids/{H}iv},
  volume = {28},
  numero = {3},
  pages = {39--51},
  ISSN = {0954-0121},
  year = {2016},
  DOI = {10.1080/09540121.2016.1164808},
  URL = {https://www.documentation.ird.fr/hor/fdi:010067744},
}