Poor Linkage to Care Despite Significant Improvement in Access to Early CART in Central Poland - Data from Test and Keep in Care (TAK) Project

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Oct 7

PMID 27711159

Citations 6

Authors

Justyna D Kowalska

Leah Shepherd

Magdalena Ankiersztejn-Bartczak

Aneta Cybula

Hanna Czeszko-Paprocka

Ewa Firlag-Burkacka

Amanda Mocroft

Andrzej Horban

Affiliations

Soon will be listed here.

Abstract

Background: The main objective of the TAK project is investigating barriers in accessing HIV care after HIV-diagnosis at the CBVCTs of central Poland. Here we describe factors associated with and changes over time in linkage to care and access to cART.

Method: Data collected in 2010-2013 in CBVCTs were linked with HIV clinics records using unique identifiers. Individuals were followed from the day of CBVCTs visit until first clinical visit or 4/06/2014. Cox-proportional hazard models were used to identify factors associated with being linked to care and starting cART.

Results: In total 232 persons were diagnosed HIV-positive and 144 (62.1% 95%CI: 55.5-68.3) persons were linked to care. There was no change over time in linkage to care (p = 0.48), while time to starting cART decreased (p = 0.02). Multivariate factors associated with a lower rate of linkage to care were hetero/bisexual sexual orientation, lower education, not having an HIV-positive partner and not using condoms in a stable relationship. Multivariate factors associated with starting cART were lower education, recent year of linked to care, and first HIV RNA and CD4 cell count.

Conclusions: Benefits of linkage to care, measured by access to early treatment, steadily improved in recent years. However at least 1 in 3 persons aware of their HIV status in central Poland remained outside professional healthcare. Persons at higher risk of remaining outside care, thus target population for future interventions, are bi/heterosexuals and those with lower levels of education.

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