Cost of point-of-care lateral flow urine lipoarabinomannan antigen testing in HIV-positive adults in South Africa

Abstract Background Mobile HIV testing approaches are a key to reaching the global targets of halting the HIV epidemic by 2030. Importantly, the number of clients reached through mobile HIV testing approaches, need to remain high to maintain the cost-effectiveness of these approaches. Advances in rapid in-vitro tests such as INSTI® HIV-1/HIV-2 (INSTI) which uses flow-through technologies, offer opportunities to reduce the HIV testing time to about one minute. Using data from a routine mobile HTS programme which piloted the use of the INSTI point-of-care (POC) test, we sought to estimate the effect of using a faster test on client testing volumes and the number of people identified to be living with HIV, in comparison with standard of care HIV rapid tests. Methods In November 2019, one out of four mobile HTS teams operating in Ekurhuleni District (South Africa) was randomly selected to pilot the field use of INSTI-POC test as an HIV screening test (i.e., the intervention team). We compared the median number of clients tested for HIV and the number of HIV-positive clients by the intervention team with another mobile HTS team (matched on performance and area of operation) which used the standard of care (SOC) HIV screening test (i.e., SOC team). Results From 19 to 20 December 2019, the intervention team tested 7,403 clients, and the SOC team tested 2,426 clients. The intervention team tested a median of 442 (IQR: 288–522) clients/day; SOC team tested a median of 97 (IQR: 40–187) clients/day (p<0.0001). The intervention team tested about 180 more males/day compared to the SOC team, and the median number of adolescents and young adults tested/day by the intervention team were almost four times the number tested by the SOC team. The intervention team identified a higher number of HIV-positive clients compared to the SOC team (142 vs. 88), although the proportion of HIV-positive clients was lower in the intervention team due to the higher number of clients tested. Conclusions This pilot programme provides evidence of high performance and high reach, for men and young people through the use of faster HIV rapid tests, by trained lay counsellors in mobile HTS units.

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Prevalence of Depression among HIV-Positive Adults on Antiretroviral Therapy in O.R. Tambo, Eastern Cape, South Africa: A cross-sectional descriptive study

10.21203/rs.3.rs-33145/v2 ◽

2020 ◽

Author(s):

Dlulane Yola Zimasa ◽

Apalata Teke ◽

Dominic Targema Abaver

Keyword(s):

South Africa ◽

Logistic Regression ◽

Antiretroviral Therapy ◽

Descriptive Study ◽

Hiv Positive ◽

Eastern Cape ◽

Cross Sectional ◽

Prevalence Of Depression ◽

Hiv Positive Adults ◽

Hiv Aids

Abstract Background Living with HIV/AIDS is associated with negative emotional and bodily symptoms; however, there is paucity of data on the prevalence and associated factors depression among this population. This study investigate the prevalence and factors contributing to depression among HIV-positive adults on antiretroviral therapy (ART) in O.R. Tambo Eastern Cape, South Africa. Method This cross-sectional descriptive study involved 334 adults receiving ART in the two Community Health Centers in OR Tambo District, Eastern Cape, South Africa. The Beck’s Depression Inventory (BDI-II) was used to collect data, in addition to a semi-structured questionnaire on coping mechanism and challenges in seeking help with depressive symptoms. Multiple logistic regression analysis were used to assess the factors associated with depression among the HIV-positive adults. Results The prevalence of depression among the HIV-positive adults receiving ART was 44%, and the majority of the patient’s depression fall within the borderline and moderate threshold. The prevalence of depression was significantly higher among females (71.0%; p < 0.0003) and unemployed (73.0%; p < 0.0014) HIV-positive adults. Participants not benefiting from any form of social grant exhibited higher prevalence of depression (79%). Race (p=0.590), age (p=0.338) and married participants (p=0.511) show no statistical significant association between HIV-positive adults accessing ART and depression. Unadjusted logistic regression model show being female (OR = 1.99, 95% CI: 1.23-3.23; p < 0.003) and unemployed (OR =1.73, 95% CI: 1.08-2.77; p < 0.014) were significantly associated with a likelihood of depression. Majority of the participants who could express their feelings of HIV disease and challenges in accessing ART felt more depressed (85%) compared to those who could not express their feelings.Conclusion The rate of depression among HIV/AIDS patients receiving ART is high. Early detection of depression and the challenges associated with accessing treatment and treating would help in improving the compliance to treatment as well as quality of life.

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