Linkage to HIV care and early retention in HIV care among men in the 'universal test-and-treat' era in a high...

Area of Science:

• Public Health
• Epidemiology
• HIV/AIDS Research

Background:

• Men in Sub-Saharan Africa, including South Africa, access HIV treatment at lower rates than women.
• The universal test-and-treat (UTT) strategy aims to improve HIV service uptake but has not fully closed the gap for men.
• This study investigates HIV care linkage and retention among men in a high-prevalence rural district.

Purpose of the Study:

• To investigate linkage to care rates for HIV-positive men in a high HIV prevalence rural district in KwaZulu-Natal, South Africa.
• To assess retention in care rates among HIV-positive men within the uThukela district.
• To understand the impact of the UTT strategy on male HIV care engagement.

Main Methods:

• An observational cohort study was conducted from January 2018 to July 2019 in 18 primary health care facilities.
• Patient data were collected using REDCap-based questionnaires in isiZulu and English at baseline, 4, and 12 months.
• Data were verified using TIER.Net, Rapid Mortality Survey, and NHLS databases and analyzed using STATA 15.1.

Main Results:

• The study included 343 HIV-positive men (median age 33 years) in the uThukela District.
• 85% of participants were linked to care within three months.
• Short-term retention in care (≤12 months) was 46% among men linked to care within three months.

Conclusions:

• The universal test-and-treat (UTT) strategy has positively influenced linkage to HIV care for men.
• Despite improved linkage, men's access to and retention in HIV treatment remains inconsistent.
• Additional innovative strategies are required to ensure consistent HIV treatment access for men.