Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data

Rivka R. Lilian; Kate Rees; James A. McIntyre; Helen E. Struthers; Remco P. H. Peters

doi:10.1371/journal.pone.0227572

Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data

Rivka R. Lilian, Kate Rees, James A. McIntyre, Helen E. Struthers, Remco P. H. Peters^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Same-day initiation (SDI) of antiretroviral therapy (ART) has been recommended to improve ART programme outcomes in South Africa since August 2017. This study assessed implementation of SDI over time in two South African districts, describing the characteristics of same-day initiators and evaluating the impact of SDI on retention in ART care. Routine data were analysed for HIV-infected adults who were newly initiating ART in Johannesburg or Mopani Districts between October 2017 and June 2018. Characteristics of same-day ART initiators were compared to later initiators, and losses to follow-up (LTFU) to six months were assessed using Kaplan Meier survival analysis and multivariate logistic regression. The dataset comprised 32 290 records (29 964 from Johannesburg and 2 326 from Mopani). The overall rate of SDI was 40.4% (n = 13 038), increasing from 30.3% in October 2017 to 54.2% in June 2018. Same-day ART initiators were younger, more likely to be female and presented with less advanced clinical disease than those initiating treatment at later times following diagnosis (p= 22 days after HIV diagnosis, respectively (p

Original language	English
Article number	0227572
Number of pages	13
Journal	PLOS ONE
Volume	15
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0227572
Publication status	Published - 14 Jan 2020

Keywords

ART INITIATION
VIRAL LOAD
CARE
LINKAGE
SUPPRESSION
PREDICTORS
RETENTION
OUTCOMES

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title = "Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data",

abstract = "Same-day initiation (SDI) of antiretroviral therapy (ART) has been recommended to improve ART programme outcomes in South Africa since August 2017. This study assessed implementation of SDI over time in two South African districts, describing the characteristics of same-day initiators and evaluating the impact of SDI on retention in ART care. Routine data were analysed for HIV-infected adults who were newly initiating ART in Johannesburg or Mopani Districts between October 2017 and June 2018. Characteristics of same-day ART initiators were compared to later initiators, and losses to follow-up (LTFU) to six months were assessed using Kaplan Meier survival analysis and multivariate logistic regression. The dataset comprised 32 290 records (29 964 from Johannesburg and 2 326 from Mopani). The overall rate of SDI was 40.4% (n = 13 038), increasing from 30.3% in October 2017 to 54.2% in June 2018. Same-day ART initiators were younger, more likely to be female and presented with less advanced clinical disease than those initiating treatment at later times following diagnosis (p= 22 days after HIV diagnosis, respectively (p",

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author = "Lilian, {Rivka R.} and Kate Rees and McIntyre, {James A.} and Struthers, {Helen E.} and Peters, {Remco P. H.}",

note = "Funding Information: This study is made possible by the generous support of the American people through the US President?s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) under Cooperative Agreement number 72067418CA00023 for the Accelerating Program Achievements to Control the Epidemic (APACE) Activity in South Africa to the Anova Health Institute. The contents are the responsibility of Anova Health Institute and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2020 Lilian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

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Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data

Abstract

Keywords

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