@article{fdi:010087820,
  title = {{I}mplementation and effectiveness of a linkage to {HIV} care intervention in rural {S}outh {A}frica ({ANRS} 12249 {T}as{P} trial)},
  author = {{P}lazy, {M}. and {D}iallo, {A}. and {H}labisa, {T}. and {O}kesola, {N}. and {I}wuji, {C}. and {H}erbst, {K}. and {B}oyer, {S}. and {L}ert, {F}. and {M}c{G}rath, {N}. and {P}illay, {D}. and {D}abis, {F}. and {L}armarange, {J}oseph and {O}rne-{G}liemann, {J}. and {ANRS} {T}as{P} {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground : {T}imely linkage to care and {ART} initiation is critical to decrease the risks of {HIV}-related morbidity, mortality and {HIV} transmission, but is often challenging. {W}e report on the implementation and effectiveness of a linkage-to-care intervention in rural {K}wa{Z}ulu-{N}atal, {S}outh {A}frica.{M}ethods : {I}n the {ANRS} 12249 {T}as{P} trial on {U}niversal {T}esting and {T}reatment ({UTT}) implemented between 2012-2016, resident individuals ?16 years were offered home-based {HIV} testing every six months.{T}hose ascertained to be {HIV}-positive were referred to trial clinics. {S}tarting {M}ay 2013, a linkage-to-care intervention was implemented in both trial arms, consisting of tracking through phone calls and/or home visits to ?re-refer? people who had not linked to care to trial clinics within three months of the first home-based referral. {F}idelity in implementing the planned intervention was described using {K}aplan-{M}eier estimation to compute conditional probabilities of being tracked and of being re-referred by the linkage-to-care team. {E}ffect of the intervention on time to linkage-to-care was analysed using a {C}ox regression model censored for death, migration, and end of data follow-up.{R}esults : {A}mong the 2,837 individuals (73.7% female) included in the analysis, 904 (32%) were tracked at least once, and 573 of them (63.4%) were re-referred. {P}robabilities of being re-referred was 17% within six months of first referral and 31% within twelve months. {C}ompared to individuals not re-referred by the intervention, linkage-to-care was significantly higher among those with at least one re-referral through phone call (adjusted hazard ratio [a{HR}] = 1.82; 95% confidence interval [95% {CI}] = 1.47-2.25), and among those with re-referral through both phone call and home visit (a{HR} = 3.94; 95% {CI} = 2.07-7.48).{C}onclusions : {P}hone calls and home visits following {HIV} testing were challenging to implement, but appeared effective in improving linkage-to-care amongst those receiving the intervention. {S}uch patient-centred strategies should be part of {UTT} programs to achieve the {UNAIDS} 95-95-95 targets},
  keywords = {{AFRIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{PL}o{S} {O}ne},
  numero = {},
  pages = {e0280479 [17 ]},
  ISSN = {1932-6203},
  year = {2023},
  DOI = {10.1371/journal.pone.0280479},
  URL = {https://www.documentation.ird.fr/hor/fdi:010087820},
}