Treatment adherence
Did home HIV testing and immediate ART work in rural KwaZulu-Natal?
Open access · cc by · source: Europe PMC
In 10 TasP clusters, 77% of 12,894 adults were contacted and HIV prevalence was 30.5%, but only 47.5% of untreated positives reached clinic care within 6 months.
How this study connects
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Study at a glance
- Design
- RCT — Descriptive first-phase results of the ANRS 12249 TasP cluster-randomised trial (10 clusters; immediate ART vs CD4 ≤350 guideline ART).
- N
- N=12894 · 12,894 registered eligible adults; 9,927 (77.0%) contacted; HIV status ascertained in 8,233.
- Population
- Resident adults ≥16 years in rural KwaZulu-Natal, South Africa (high HIV-prevalence communities).
- Outcome
- Home-based HIV testing uptake, 6-month linkage to trial clinics, 3-month ART initiation, and community ART attitudes.
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Did home HIV testing and immediate ART work in rural KwaZulu-Natal?
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
12,894 adults were registered; 9,927 (77.0%) were contacted at least once.
In all, 12,894 adults were registered as eligible for participation (5,790 in intervention arm; 7,104 in control arm), of whom 9,927 (77.0%) were contacted at least once during household visits.
HIV prevalence was 30.5% (2,028/6,656).
Estimated baseline HIV prevalence was 30.5% (2,028/6,656) (95% CI 25.0%, 37.0%).
Key findings
HIV status was ascertained in 82.9% of those contacted. Linkage within 6 months was 47.5% (559/1,177). Immediate-ART initiators started within 3 months in 89% (194/218). 93% said they would want ART as soon as possible if HIV-positive. Men were harder to find at home (53.3% vs 75.2% contact).
Methodology
Visited households every 6 months (Mar 2012–May 2014), offered rapid HIV tests, referred all positives to cluster clinics, and compared immediate ART versus South African CD4 ≤350 guidelines in five clusters per arm.
Limitations
This first-phase implementation report cannot yet show whether universal ART cut population HIV incidence; noncontact (especially of men) may bias uptake estimates.
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