Implementation and effectiveness of a linkage to HIV care intervention in rural South Africa (ANRS 12249 TasP trial) Plazy, M. Diallo, A. Hlabisa, T. Okesola, N. Iwuji, C. Herbst, K. Boyer, S. Lert, F. McGrath, N. Pillay, D. Dabis, F. /Larmarange, Joseph Orne-Gliemann, J. ANRS TasP Study Group Background : Timely linkage to care and ART initiation is critical to decrease the risks of HIV-related morbidity, mortality and HIV transmission, but is often challenging. We report on the implementation and effectiveness of a linkage-to-care intervention in rural KwaZulu-Natal, South Africa.Methods : In the ANRS 12249 TasP trial on Universal Testing and Treatment (UTT) implemented between 2012-2016, resident individuals ?16 years were offered home-based HIV testing every six months.Those ascertained to be HIV-positive were referred to trial clinics. Starting May 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. Fidelity in implementing the planned intervention was described using Kaplan-Meier estimation to compute conditional probabilities of being tracked and of being re-referred by the linkage-to-care team. Effect of the intervention on time to linkage-to-care was analysed using a Cox regression model censored for death, migration, and end of data follow-up.Results : Among 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. Probabilities of being re-referred was 17% within six months of first referral and 31% within twelve months. Compared 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 [aHR] = 1.82; 95% confidence interval [95% CI] = 1.47-2.25), and among those with re-referral through both phone call and home visit (aHR = 3.94; 95% CI = 2.07-7.48).Conclusions : Phone calls and home visits following HIV testing were challenging to implement, but appeared effective in improving linkage-to-care amongst those receiving the intervention. Such patient-centred strategies should be part of UTT programs to achieve the UNAIDS 95-95-95 targets 2023 text https://www.documentation.ird.fr/hor/fdi:010087820 fdi:010087820 Plazy M., Diallo A., Hlabisa T., Okesola N., Iwuji C., Herbst K., Boyer S., Lert F., McGrath N., Pillay D., Dabis F., Larmarange Joseph, Orne-Gliemann J., ANRS TasP Study Group. Implementation and effectiveness of a linkage to HIV care intervention in rural South Africa (ANRS 12249 TasP trial). 2023, e0280479 [17 ] EN AFRIQUE DU SUD