%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Plazy, M.
%A Diallo, A.
%A Hlabisa, T.
%A Okesola, N.
%A Iwuji, C.
%A Herbst, K.
%A Boyer, S.
%A Lert, F.
%A McGrath, N.
%A Pillay, D.
%A Dabis, F.
%A Larmarange, Joseph
%A Orne-Gliemann, J.
%A ANRS TasP Study Group
%T Implementation and effectiveness of a linkage to HIV care intervention in rural South Africa (ANRS 12249 TasP trial)
%D 2023
%L fdi:010087820
%G ENG
%J PLoS One
%@ 1932-6203
%K AFRIQUE DU SUD
%M ISI:000967499900001
%P e0280479 [17 ]
%R 10.1371/journal.pone.0280479
%U https://www.documentation.ird.fr/hor/fdi:010087820
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-08/010087820.pdf
%W Horizon (IRD)
%X 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
%$ 052MALTRA03 ; 056SOCSAN