London School of Hygiene and Tropical Medicine, London, UK.
Zambart, School of Medicine, University of Zambia, Ridgeway Campus, Lusaka, Zambia.
AIDS Behav. 2019 Apr;23(4):929-946. doi: 10.1007/s10461-018-2335-7.
To achieve UNAIDS 90:90:90 targets at population-level, knowledge of HIV status must be followed by timely linkage to care, initiation and maintenance of antiretroviral therapy (ART) for all people living with HIV (PLHIV). Interpreting quantitative patterns using qualitative data, we investigate time taken to link to care and initiate ART amongst individuals aware of their HIV-status in high HIV-prevalence urban communities in the HPTN 071 (PopART) study, a community-randomised trial of a combination HIV prevention package, including universal testing and treatment, in 21 communities in Zambia and South Africa. Data are drawn from the seven intervention communities where immediate ART irrespective if CD4 count was offered from the trial-start in 2014. Median time from HIV-diagnosis to ART initiation reduced after 2 years of delivering the intervention from 10 to 6 months in both countries but varied by gender and community of residence. Social and health system realities impact decisions made by PLHIV about ART initiation.
为了实现联合国艾滋病规划署 90-90-90 目标，即所有艾滋病毒感染者（PLHIV）必须了解其艾滋病毒状况，随后及时获得护理、开始并维持抗逆转录病毒治疗（ART）。本研究采用定性数据解读定量模式，调查了在 HPTN 071（PopART）研究中，艾滋病毒高流行城市社区中，知晓自身艾滋病毒状况的个体在获得护理和开始 ART 方面所花费的时间，该研究是一项在赞比亚和南非 21 个社区开展的社区随机试验，旨在评估包括普遍检测和治疗在内的综合艾滋病毒预防措施包。数据来自于从 2014 年试验开始就提供无论 CD4 计数如何都立即开始 ART 的 7 个干预社区。在实施干预措施两年后，两国从 HIV 诊断到开始 ART 的中位时间从 10 个月缩短到 6 个月，但因性别和居住社区而异。PLHIV 对开始 ART 的决定受到社会和卫生系统现实的影响。
