Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya.
Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18-25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrollment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 50 Beale Street, Suite 1200, San Francisco, CA 94105, USA. HatcherA@globalhealth.ucsf.edu
Abigail M
AM
Hatcher
Janet M
JM
Turan
Hannah H
HH
Leslie
Lucy W
LW
Kanya
Zachary
Z
Kwena
Malory O
MO
Johnson
Starley B
SB
Shade
Elizabeth A
EA
Bukusi
Alexandre
A
Doyen
Craig R
CR
Cohen
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012650:Self Disclosure; D057566:Self Report; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
D019380:Anti-HIV Agents