Loss to Initiation of HIV Care and Treatment in South Africa

Project Description

The successful expansion of access to HIV testing in sub-Saharan Africa has led to hundreds of thousands of people learning that they are HIV-positive. Only a small fraction of these individuals, however, are enrolling in HIV/AIDS care and treatment programs at the time of diagnosis or at any time before they become seriously ill. As a result, most patients seek HIV/AIDS treatment long after they were eligible and with severe illness.

Several of the CGHD’s analyses on improving the outcomes of HIV/AIDS treatment have focused on the period between testing positive for HIV and initiating treatment with ARVs. As a starting point for designing interventions to reduce late presentation for care, we reviewed testing and care records at one large public-sector treatment program in Johannesburg to estimate rates of loss at two points in the testing-to-treatment continuum: 1) between testing positive for HIV and returning for CD4 count (staging) results and 2) between enrolling in the pre-ART care program and returning for the first medical appointment. Our findings on loss to initiation are informing the current debate about what interventions will have the greatest impact on linking patients to HIV care after testing positive.

This project is one activity of the CGHD’s Economics and Epidemiology of HIV/AIDS Care and Treatment (South Africa Associate Award).

Project Details

Principal Investigator Bruce Larson
Boston University Co-Investigators Sydney Rosen, Matthew Fox, Alana Brennan
Collaborators
Donor/Funder USAID logo United States Agency for International Development (USAID)
Dates of Research 2007 – current
Country(ies) South Africa