Email this article 
Hide
Show all
Original Research
Outcomes from the implementation of a counselling model supporting rapid antiretroviral treatment initiation in a primary healthcare clinic in Khayelitsha, South Africa
Submitted: 01 March 2015 | Published: 02 July 2015
About the author(s)
Lynne Wilkinson, Médecins Sans Frontières, Khayelitsha Project, South AfricaHelene Duvivier, Médecins Sans Frontières, South African Mission, South Africa
Gabriela Patten, Médecins Sans Frontières, Khayelitsha Project, South Africa
Suhair Solomon, Médecins Sans Frontières, Khayelitsha Project, South Africa
Leticia Mdani, Médecins Sans Frontières, Khayelitsha Project, South Africa
Shariefa Patel, City of Cape Town Health Department, Khayelitsha,, South Africa
Virginia de Azevedo, City of Cape Town Health Department, Khayelitsha, South Africa
Saar Baert, Médecins Sans Frontières, South African Medical Unit, Belgium
Abstract
Background: Lengthy antiretroviral treatment (ART) preparation contributes to high lossesto care between communicating ART eligibility and initiating ART. To address this shortfall, Médecins Sans Frontières implemented a revised approach to ART initiation counsellingpreparation (integrated for TB co-infected patients), shifting the emphasis frompre-initiation sessions to addressing common barriers to adherence and strengthening postinitiationsupport in a primary healthcare facility in Khayelitsha, South Africa.
Methods: An observational cohort study was conducted using routinely collected data forall ART-eligible patients attending their first counselling session between 23 July 2012 and 30April 2013 to assess losses to care prior to and post ART initiation. Viral load completion andsuppression rates of those retained on ART were also calculated.
Results: Overall, 449 patients enrolled in the study, of whom 3.6% did not return to the facilityto initiate ART. Of those who were initiated, 96.7% were retained at their first ART refill visitand 85.9% were retained 6 months post ART initiation. Of those retained, 80.2% had a viralload taken within 6 months of initiating ART, with 95.4% achieving viral load suppression.
Conclusions: Adapting counselling to enable rapid ART initiation is feasible and has thepotential to reduce losses to care prior to ART initiation without increasing short-term lossesthereafter or compromising patient adherence.
Keywords
Metrics
Total abstract views: 6910Total article views: 9719
Crossref Citations
1. Same‐day antiretroviral therapy is associated with increased loss to follow‐up in South African public health facilities: a prospective cohort study of patients diagnosed with HIV
Dvora Joseph Davey, Kathleen Kehoe, Claire Serrao, Marlien Prins, Ntokozo Mkhize, Khanyo Hlophe, Senate Sejake, Todd Malone
Journal of the International AIDS Society vol: 23 issue: 6 year: 2020
doi: 10.1002/jia2.25529
2. Same‐day antiretroviral therapy initiation for people living with HIV who have tuberculosis symptoms: a systematic review
Rachael M. Burke, Hannah M. Rickman, Vindi Singh, Thokozani Kalua, Niklaus D. Labhardt, Mina Hosseinipour, Robert J. Wilkinson, Peter MacPherson
HIV Medicine vol: 23 issue: 1 first page: 4 year: 2022
doi: 10.1111/hiv.13169
3. A Conditional Economic Incentive Fails to Improve Linkage to Care and Antiretroviral Therapy Initiation Among HIV-Positive Adults in Cape Town, South Africa
Brendan Maughan-Brown, Philip Smith, Caroline Kuo, Abigail Harrison, Mark N. Lurie, Linda-Gail Bekker, Omar Galárraga
AIDS Patient Care and STDs vol: 32 issue: 2 first page: 70 year: 2018
doi: 10.1089/apc.2017.0238
4. “Now We Are Told That We Can Mix”: Messages and Beliefs Around Simultaneous Use of Alcohol and ART
Emily N. Satinsky, Bronwyn Myers, Lena S. Andersen, Ashraf Kagee, John Joska, Jessica F. Magidson
AIDS and Behavior vol: 24 issue: 9 first page: 2680 year: 2020
doi: 10.1007/s10461-020-02825-1
5. “I Have to Push Him with a Wheelbarrow to the Clinic”: Community Health Workers' Roles, Needs, and Strategies to Improve HIV Care in Rural South Africa
Kelsey B. Loeliger, Linda M. Niccolai, Lillian N. Mtungwa, Anthony Moll, Sheela V. Shenoi
AIDS Patient Care and STDs vol: 30 issue: 8 first page: 385 year: 2016
doi: 10.1089/apc.2016.0096
6. Stumbling Blocks at the Clinic: Experiences of Seeking HIV Treatment and Care in South Africa
Brendan Maughan-Brown, Caroline Kuo, Omar Galárraga, Philip Smith, Mark N. Lurie, Linda-Gail Bekker, Abigail Harrison
AIDS and Behavior vol: 22 issue: 3 first page: 765 year: 2018
doi: 10.1007/s10461-017-1877-4
7. Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data
Rivka R. Lilian, Kate Rees, James A. McIntyre, Helen E. Struthers, Remco P. H. Peters, Marcel Yotebieng
PLOS ONE vol: 15 issue: 1 first page: e0227572 year: 2020
doi: 10.1371/journal.pone.0227572
8. Optimising treatment in the test-and-treat strategy: what are we waiting for?
Nittaya Phanuphak, Pich Seekaew, Praphan Phanuphak
The Lancet HIV vol: 6 issue: 10 first page: e715 year: 2019
doi: 10.1016/S2352-3018(19)30236-X
9. Benefits and Risks of Rapid Initiation of Antiretroviral Therapy: A Systematic Review and Meta-Analysis
Ruojing Bai, Juan Du, Shiyun Lv, Wei Hua, Lili Dai, Hao Wu
Frontiers in Pharmacology vol: 13 year: 2022
doi: 10.3389/fphar.2022.898449
10. Factors influencing treatment adherence in hypertension and HIV management in South Africa: A comparative literature review
Dimitra Enslin, Prabhakar Mallya
South African Family Practice vol: 64 issue: 1 year: 2022
doi: 10.4102/safp.v64i1.5434
11. Rapid initiation of antiretroviral therapy for people living with HIV
Alberto Mateo-Urdiales, Samuel Johnson, Rhodine Smith, Jean B Nachega, Ingrid Eshun-Wilson
Cochrane Database of Systematic Reviews year: 2019
doi: 10.1002/14651858.CD012962.pub2
12. Patient-centred care: reality or rhetoric—patients’ experiences at ARV clinics located in public hospitals in KwaZulu-Natal, South Africa
Delarise M. Mulqueeny, Myra Taylor
AIDS Research and Therapy vol: 19 issue: 1 year: 2022
doi: 10.1186/s12981-022-00463-2
13. Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe
Florian Vogt, Andrea M. Rehman, Katharina Kranzer, Mary Nyathi, Johan Van Griensven, Mark Dixon, Wedu Ndebele, Hilary Gunguwo, Robert Colebunders, Mbongeni Ndlovu, Tsitsi Apollo, Rashida A. Ferrand
JAIDS Journal of Acquired Immune Deficiency Syndromes vol: 74 issue: 4 first page: 390 year: 2017
doi: 10.1097/QAI.0000000000001274
14. HIV patients retention and attrition in care and their determinants in Ethiopia: a systematic review and meta-analysis
Nurilign Abebe Moges, Adesina Olubukola, Okunlola Micheal, Yemane Berhane
BMC Infectious Diseases vol: 20 issue: 1 year: 2020
doi: 10.1186/s12879-020-05168-3
15. Accelerating the Uptake and Timing of Antiretroviral Therapy Initiation in Sub-Saharan Africa: An Operations Research Agenda
Sydney Rosen, Matthew P. Fox, Bruce A. Larson, Papa Salif Sow, Peter D. Ehrenkranz, Francois Venter, Yukari C. Manabe, Jonathan Kaplan
PLOS Medicine vol: 13 issue: 8 first page: e1002106 year: 2016
doi: 10.1371/journal.pmed.1002106
16. Estimating the impact of antiretroviral treatment on adult mortality trends in South Africa: A mathematical modelling study
Leigh F. Johnson, Margaret T. May, Rob E. Dorrington, Morna Cornell, Andrew Boulle, Matthias Egger, Mary-Ann Davies, Amitabh Bipin Suthar
PLOS Medicine vol: 14 issue: 12 first page: e1002468 year: 2017
doi: 10.1371/journal.pmed.1002468
17. Rapid initiation of antiretroviral therapy for people living with HIV
Alberto Mateo-Urdiales, Samuel Johnson, Jean B Nachega, Ingrid Eshun-Wilson
Cochrane Database of Systematic Reviews year: 2018
doi: 10.1002/14651858.CD012962
18. Differentiated HIV care in South Africa: the effect of fast‐track treatment initiation counselling on ART initiation and viral suppression as partial results of an impact evaluation on the impact of a package of services to improve HIV treatment adherence
Sophie JS Pascoe, Matthew P Fox, Amy N Huber, Joshua Murphy, Mokgadi Phokojoe, Marelize Gorgens, Sydney Rosen, David Wilson, Yogan Pillay, Nicole Fraser‐Hurt
Journal of the International AIDS Society vol: 22 issue: 11 year: 2019
doi: 10.1002/jia2.25409
19. Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa
Leigh F. Johnson, Rob E. Dorrington, Haroon Moolla
Southern African Journal of HIV Medicine vol: 18 issue: 1 year: 2017
doi: 10.4102/sajhivmed.v18i1.694
20. Benefits and risks of rapid initiation of antiretroviral therapy
Nathan Ford, Chantal Migone, Alexandra Calmy, Bernhard Kerschberger, Steve Kanters, Sabin Nsanzimana, Edward J. Mills, Graeme Meintjes, Marco Vitoria, Meg Doherty, Zara Shubber
AIDS vol: 32 issue: 1 first page: 17 year: 2018
doi: 10.1097/QAD.0000000000001671
21. Failure to initiate HIV treatment in patients with high CD4 counts: evidence from demographic surveillance in rural South Africa
Jacob Bor, Calvin Chiu, Shahira Ahmed, Ingrid Katz, Matthew P. Fox, Sydney Rosen, Manisha Yapa, Frank Tanser, Deenan Pillay, Till Bärnighausen
Tropical Medicine & International Health vol: 23 issue: 2 first page: 206 year: 2018
doi: 10.1111/tmi.13013
22. Evaluation of the clinical outcomes of the Test and Treat strategy to implement Treat All in Nigeria: Results from the Nigeria Multi-Center ART Study
Kristen A. Stafford, Solomon F. Odafe, Julia Lo, Ramat Ibrahim, Akipu Ehoche, Mercy Niyang, Gambo G. Aliyu, Bola Gobir, Dennis Onotu, Ademola Oladipo, Ibrahim Dalhatu, Andrew T. Boyd, Otse Ogorry, Lawal Ismail, Manhattan Charurat, Mahesh Swaminathan, Kwasi Torpey
PLOS ONE vol: 14 issue: 7 first page: e0218555 year: 2019
doi: 10.1371/journal.pone.0218555
23. “Dispense antiretrovirals daily!” restructuring the delivery of HIV services to optimize antiretroviral initiation among men in Malawi
Alinane Linda Nyondo-Mipando, Leticia Suwedi Kapesa, Sangwani Salimu, Thokozani Kazuma, Victor Mwapasa, Jeremiah Chikovore
PLOS ONE vol: 16 issue: 2 first page: e0247409 year: 2021
doi: 10.1371/journal.pone.0247409