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Testing modality associated with fast-track ART initiation in Botswana.
Marie-Claude C Lavoie1,2, Natalia Blanco1, Koona Keapoletswe3
1Center for International Health, Education, and Biosecurity (Ciheb), Institute of Human Virology (IHV), University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.
Tropical Medicine & International Health : TM & IH
|March 17, 2022
Summary
Index HIV testing in Botswana significantly speeds up antiretroviral therapy (ART) initiation for newly diagnosed individuals. This community-based approach is crucial for timely HIV treatment and program improvement.
Area of Science:
- Public Health
- Epidemiology
- HIV/AIDS Research
Background:
- Timely initiation of antiretroviral therapy (ART) is critical for managing HIV/AIDS.
- Community-based HIV testing modalities play a role in reaching diverse populations.
Purpose of the Study:
- To identify community testing strategies linked to rapid ART initiation in Botswana.
- To evaluate the effectiveness of different HIV testing methods on ART uptake.
Main Methods:
- Retrospective cohort study of HIV-positive individuals aged 15+ in Botswana (May 2017-Jan 2019).
- Poisson regression and generalized linear mixed models were used to analyze ART initiation within 7 and 30 days.
- Factors considered included testing modality and demographic data.
Main Results:
- 22% of individuals started ART within 7 days of diagnosis.
- Index testing was associated with higher likelihood of ART initiation within 7 days (aRR=1.38) and 30 days (aRR=1.17) compared to mobile/outreach testing.
- Men constituted 60% of newly diagnosed HIV-positive individuals.
Conclusions:
- Community HIV testing, particularly index testing, accelerates ART initiation.
- Monitoring testing modalities is essential for optimizing HIV treatment programs.
- Index testing effectively reaches populations, including men, who may not access facility-based services.
