Human immunodeficiency virus care cascade among sub-populations in Rakai, Uganda: an observational study

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dc.contributor.authorBillioux, Veena G.
dc.contributor.authorChang, Larry W.
dc.contributor.authorReynolds, Steven J.
dc.contributor.authorNakigozi, Gertrude
dc.contributor.authorSsekasanvu, Joseph
dc.contributor.authorGrabowski, Mary K.
dc.contributor.authorSsekubugu, Robert
dc.contributor.authorNalugoda, Fred
dc.contributor.authorKigozi, Godfrey
dc.contributor.authorKagaayi, Joseph
dc.contributor.authorSerwadda, David
dc.contributor.authorGray, Ronald H.
dc.contributor.authorWawer, Maria J.
dc.date.accessioned2022-03-11T07:05:17Z
dc.date.available2022-03-11T07:05:17Z
dc.date.issued2017
dc.description.abstractTo assess progress towards the UNAIDS 90–90–90 initiative targets, we examined the HIV care cascade in the population-based Rakai Community Cohort Study (RCCS) in rural Uganda and examined differences between sub-groups. Methods: Self-reports and clinical records were used to assess the proportion achieving each stage in the cascade. Statistical inference based on a 2 test for categorical variables and modified Poisson regression were used to estimate prevalence risk ratios (PRRs) and 95% confidence intervals (CI) for enrolment into care and initiating antiretroviral therapy (ART). Results: From September 2013 through December 2015, 3,666 HIV-positive participants were identified in the RCCS. As of December 2015, 98% had received HIV Counseling and Testing (HCT), 74% were enrolled in HIV care, and 63% had initiated ART of whom 92% were virally suppressed after 12 months on ART. Engagement in care was lower among men than women (enrolment in care: adjPRR 0.84, 95% CI 0.77–0.91; ART initiation: adjPRR 0.75, 95% CI 0.69–0.82), persons aged 15–24 compared to those aged 30–39 (enrolment: adjPRR 0.72, 95% CI 0.63–0.82; ART: adjPRR 0.69, 95%CI 0.60–0.80), unmarried persons (enrolment: adjPRR 0.84, 95% CI 0.71–0.99; ART adjPRR 0.80, 95% CI 0.66–0.95), and new in-migrants (enrolment: adjPRR 0.75, 95% CI 0.67–0.83; ART: adjPRR 0.76, 95% CI 0.67–0.85). This cohort achieved 98–65–92 towards the UNAIDS “90–90–90” targets with an estimated 58% of the entire HIV-positive RCCS population virally suppressed. Conclusions: This cohort achieved over 90% in both HCT and viral suppression among ART users, but only 65% in initiating ART, likely due to both an ART eligibility criterion of <500 CD4 cells/mL and suboptimal entry into care among men, younger individuals, and in-migrants. Interventions are needed to promote enrolment in HIV care, particular for hard-to-reach subpopulations.en_US
dc.identifier.citationBillioux, V. G., Chang, L. W., Reynolds, S. J., Nakigozi, G., Ssekasanvu, J., Grabowski, M. K., ... & Rakai Health Sciences Program. (2017). Human immunodeficiency virus care cascade among sub‐populations in Rakai, Uganda: an observational study. Journal of the International AIDS Society, 20(1), 21590. http://dx.doi.org/10.7448/IAS.20.1.21590en_US
dc.identifier.urihttp://dx.doi.org/10.7448/IAS.20.1.21590
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2679
dc.language.isoenen_US
dc.publisherJournal of the International AIDS Societyen_US
dc.subjectHIVen_US
dc.subjectAntiretroviralen_US
dc.subjectHIV care cascadeen_US
dc.subjectRakaien_US
dc.subjectUgandaen_US
dc.titleHuman immunodeficiency virus care cascade among sub-populations in Rakai, Uganda: an observational studyen_US
dc.typeArticleen_US
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