Population uptake of antiretroviral treatment through primary care in rural South Africa

Cooke, G.S., Tanser, F., Bärnighausen, T.W. and Newell, M.-L. (2010) Population uptake of antiretroviral treatment through primary care in rural South Africa. BMC Public Health, 10 . ISSN 1471-2458

Full content URL: http://doi.org/10.1186/1471-2458-10-585

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Item Type:Article
Item Status:Live Archive

Abstract

Background
KwaZulu-Natal is the South African province worst affected by HIV and the focus of early modeling studies investigating strategies of antiretroviral treatment (ART) delivery. The reality of antiretroviral roll-out through primary care has differed from that anticipated and real world data are needed to inform the planning of further scaling up of services. We investigated the factors associated with uptake of antiretroviral treatment through a primary healthcare system in rural South Africa.

Methods
Detailed demographic, HIV surveillance and geographic information system (GIS) data were used to estimate the proportion of HIV positive adults accessing antiretroviral treatment within northern KwaZulu-Natal, South Africa in the period from initiation of antiretroviral roll-out until the end of 2008. Demographic, spatial and socioeconomic factors influencing the likelihood of individuals accessing antiretroviral treatment were explored using multivariable analysis.

Results
Mean uptake of ART among HIV positive resident adults was 21.0% (95%CI 20.1-21.9). Uptake among HIV positive men (19.2%) was slightly lower than women (21.8%, P = 0.011). An individual's likelihood of accessing ART was not associated with level of education, household assets or urban/rural locale. ART uptake was strongly negatively associated with distance from the nearest primary healthcare facility (aOR = 0.728 per square-root transformed km, 95%CI 0.658-0.963, P = 0.002).

Conclusions
Despite concerns about the equitable nature of antiretroviral treatment rollout, we find very few differences in ART uptake across a range of socio-demographic variables in a rural South African population. However, even when socio-demographic factors were taken into account, individuals living further away from primary healthcare clinics were still significantly less likely to be accessing ART

Additional Information:cited By 55
Divisions:College of Social Science > Lincoln Institute of Health
ID Code:37489
Deposited On:07 Oct 2019 14:16

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