scholarly journals Retention in HIV Care for Individuals Not Yet Eligible for Antiretroviral Therapy: Rural KwaZulu-Natal, South Africa

2011 ◽  
Vol 56 (3) ◽  
pp. e79-e86 ◽  
Author(s):  
Richard J Lessells ◽  
Portia C Mutevedzi ◽  
Graham S Cooke ◽  
Marie-Louise Newell
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Hiv Care ◽  
Retention In Hiv Care ◽  
Kwazulu Natal

scholarly journals Why do patients interrupt and return to antiretroviral therapy? Retention in HIV care from the patient’s perspective in Johannesburg, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256540
Author(s):  
Melanie A. Bisnauth ◽  
Natasha Davies ◽  
Sibongile Monareng ◽  
Fezile Buthelezi ◽  
Helen Struthers ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Health Services ◽  
Healthcare Providers ◽  
Retention In Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Related Factors ◽  
Retention In Hiv Care

Background Retention in care is required for optimal clinical outcomes in people living with HIV (PLHIV). Although most PLHIV in South Africa know their HIV status, only 70% are on antiretroviral therapy (ART). Improved retention in care is needed to get closer to sustained ART for all. In January 2019, Anova Health Institute conducted a campaign to encourage patients who had interrupted ART to return to care. Methods Data collection was conducted in one region of Johannesburg. This mixed methods study consisted of two components: 1) healthcare providers entered data into a structured tool for all patients re-initiating ART at nine clinics over a nine-month period, 2) Semi-structured interviews were conducted with a sub-set of patients. Responses to the tool were analysed descriptively, we report frequencies, and percentages. A thematic approach was used to analyse participant experiences in-depth. Results 562 people re-initiated ART, 66% were women, 75% were 25–49 years old. The three most common reasons for disengagement from care were mobility (30%), ART related factors (15%), and time limitations due to work (10%). Reasons for returning included it becoming easier to attend the clinic (34%) and worry about not being on ART (19%). Mobile interview participants often forgot their medical files and expressed that managing their ART was difficult because they often needed a transfer letter to gain access to ART at another facility. On the other hand, clinics that had flexible and extended hours facilitated retention in care. Conclusion In both the quantitative data, and the qualitative analysis, changing life circumstances was the most prominent reason for disengagement from care. Health services were not perceived to be responsive to life changes or mobility, leading to disengagement. More client-centred and responsive health services should improve retention on ART.

scholarly journals The effect of eligibility for antiretroviral therapy on body mass index and blood pressure in KwaZulu-Natal, South Africa

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aditi Kuber ◽  
Anna Reuter ◽  
Pascal Geldsetzer ◽  
Natsayi Chimbindi ◽  
Mosa Moshabela ◽  
...  
Keyword(s):  
South Africa ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Antiretroviral Therapy ◽  
Body Mass ◽  
Treatment Guidelines ◽  
Causal Effect ◽  
Regression Discontinuity Design ◽  
National Treatment ◽  
Kwazulu Natal

AbstractWe use a regression discontinuity design to estimate the causal effect of antiretroviral therapy (ART) eligibility according to national treatment guidelines of South Africa on two risk factors for cardiovascular disease, body mass index (BMI) and blood pressure. We combine survey data collected in 2010 in KwaZulu-Natal, South Africa, with clinical data on ART. We find that early ART eligibility significantly reduces systolic and diastolic blood pressure. We do not find any significant effects on BMI. The effect on blood pressure can be detected up to three years after becoming eligible for ART.

Comparing effectiveness of first‐line antiretroviral therapy between peri‐urban and rural clinics in KwaZulu‐Natal, South Africa

HIV Medicine ◽  
2022 ◽  
Author(s):  
Jaysingh Brijkumar ◽  
Johnathan A. Edwards ◽  
Brent A. Johnson ◽  
Claudia Ordonez ◽  
Henry Sunpath ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
First Line ◽  
Kwazulu Natal ◽  
Rural Clinics

scholarly journals PIMATM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Mandisa Skhosana ◽  
Shabashini Reddy ◽  
Tarylee Reddy ◽  
Siphelele Ntoyanto ◽  
Elizabeth Spooner ◽  
...  
Keyword(s):  
South Africa ◽  
T Cells ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Point Of Care ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Kwazulu Natal ◽  
Cd4 T Cell Count

Introduction: Limited information is available on the usefulness of the PIMATM analyser in predicting antiretroviral treatment eligibility and outcome in a primary healthcare clinic setting in disadvantaged communities in KwaZulu-Natal, South Africa.Materials and methods: The study was conducted under the eThekwini Health Unit, Durban, KwaZulu-Natal. Comparison of the enumeration of CD4+ T-cells in 268 patients using the PIMATM analyser and the predicate National Health Laboratory Services (NHLS) was undertaken during January to July 2013. Bland-Altman analysis to calculate bias and limits of agreement, precision and levels of clinical misclassification at various CD4+ T-cell count thresholds was performed.Results: There was high precision of the PIMATM control bead cartridges with low and normal CD4+ T-cell counts using three different PIMATM analysers (%CV < 5). Under World Health Organization (WHO) guidelines (≤ 500 cells/mm3), the sensitivity of the PIMATM analyser was 94%, specificity 78% and positive predictive value (PPV) 95%. There were 24 (9%) misclassifications, of which 13 were false-negative in whom the mean bias was 149 CD4+ T-cells/mm3. Most (87%) patients returned for their CD4 test result but only 67% (110/164) of those eligible (≤ 350 cells/mm3) were initiated on antiretroviral therapy (ART) with a time to treatment of 49 days (interquartile range [IQR], 42–64 days).Conclusion: There was adequate agreement between PIMATM analyser and predicate NHLS CD4+ T-cell count enumeration (≤ 500 cells/mm3) in adult HIV-positive individuals. The high PPV, sensitivity and acceptable specificity of the PIMATM analyser technology lend it as a reliable tool in predicting eligibility and rapid linkage to care in ART programmes.Keywords: HIV; Point of Care; PIMATM CD4+ T cell counts; antiretroviral therapy; prediction/eligibility; South Africa

Symptoms experienced by HIV-infected Individuals on antiretroviral therapy in KwaZulu-Natal, South Africa

2011 ◽  
Vol 24 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Busisiwe R. Bhengu ◽  
Busisiwe P. Ncama ◽  
Patricia A. McInerney ◽  
Dean J. Wantland ◽  
Patrice K. Nicholas ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Kwazulu Natal

scholarly journals The Nutritional Status of Adult Antiretroviral Therapy Recipients with a Recent HIV Diagnosis; A Cross-Sectional Study in Primary Health Facilities in Gauteng, South Africa

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 290
Author(s):  
Khabo Mahlangu ◽  
Perpetua Modjadji ◽  
Sphiwe Madiba
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Nutritional Status ◽  
Health Facilities ◽  
The Body ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.

scholarly journals High incidence and persistence of hepatitis B virus infection in individuals receiving HIV care in KwaZulu-Natal, South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nokukhanya Msomi ◽  
Kogieleum Naidoo ◽  
Nonhlanhla Yende-Zuma ◽  
Nesri Padayatchi ◽  
Kerusha Govender ◽  
...  
Keyword(s):  
South Africa ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hbv Infection ◽  
Hiv Care ◽  
Care Provision ◽  
Hbsag Positivity ◽  
Kwazulu Natal ◽  
B Virus ◽  
Clinical Records

Abstract Background Hepatitis B virus (HBV), Human Immunodeficiency virus (HIV) and Tuberculosis (TB) are common infections in South Africa. We utilized the opportunity of care provision for HIV-TB co-infected patients to better understand the relationship between these coinfections, determine the magnitude of the problem, and identify risk factors for HBV infection in HIV infected patients with and without TB in KwaZulu-Natal, South Africa. Methods This retrospective cohort analysis was undertaken in 2018. In-care HIV infected patients were included in the analysis. Results from clinical records were analysed to determine the prevalence, incidence, persistence and factors associated with HBsAg positivity in HIV-infected patients with or without TB co-infection. Results A total of 4292 HIV-infected patients with a mean age of 34.7 years (SD: 8.8) were included. Based on HBsAg positivity, the prevalence of HBV was 8.5% (363/4292) [95% confidence interval (CI): 7.7–9.3] at baseline and 9.4% (95%CI: 8.6–10.3%) at end of follow-up. The HBV incidence rate was 2.1/100 person-years (p-y). Risk of incident HBV infection was two-fold higher among male patients (HR 2.11; 95% CI: 1.14–3.92), while severe immunosuppression was associated with a greater than two-fold higher risk of persistent infection (adjusted risk ratio (RR) 2.54; 95% CI 1.06–6.14; p = 0.004. Additionally, active TB at enrolment was associated with a two-fold higher risk of incident HBV infection (aHR 2.38; 95% CI: 0.77–7.35). Conclusion The provision of HIV care and treatment in high HBV burden settings provide a missed opportunity for HBV screening, immunization and care provision.

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