Between HIV diagnosis and initiation of antiretroviral therapy: Assessing the effectiveness of care for people living with HIV in the public primary care service in Cape Town, South Africa

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dc.contributor.authorScott, Vera
dc.contributor.authorZweigenthal, Virginia
dc.contributor.authorJennings, Karen
dc.date.accessioned2011-10-12T13:43:14Z
dc.date.available2011-10-12T13:43:14Z
dc.date.issued2011
dc.description.abstractBACKGROUND: While much is written about the scale up of HIV counselling and testing (HCT) and antiretroviral therapy (ART), little research has been done on the expansion of routine preART HIV care. OBJECTIVE: To assess the quality of preART care in Cape Town and its continuity with HCT and ART. METHODS: The scale up of the HCT, preART and ART service platform and programmatic support in Cape Town is described. Data from the August 2010 routine annual HIV/TB/STI evaluation, from interviews with 133 facility managers and a folder review of 634 HCT s who tested positive and 1115 clients receiving preART HIV care are analysed. RESULTS: Historically the implementation and management of preART care has been relatively neglected compared with the scale-up of HCT and ART. The CD4 count was done on 77.5% positive HCT clients and 46.6% were clinically staged - crucial steps that determine the care path. There were: gaps in quality of care - 32.2% of women had a PAP smear; missed opportunities for integrated care - 67% were symptomatically screened for tuberculosis; and positive prevention - 48.3% had contraceptive needs assessed. Breaks in the continuity of care of preART clients occurred with only 47.2% of eligible clients referred appropriately to the ARV service. CONCLUSION: While a package of preART care has been clearly defined in Cape Town, it has not been fully implemented. There are weaknesses in the continuity and quality service delivered that undermine the programme objectives of provision of positive prevention and timeous access to ART.en_US
dc.identifier.citationScott, V.E., Zweigenthal, V., & Jennings, K. (2011). Between HIV diagnosis and initiation of antiretroviral therapy: Assessing the effectiveness of care for people living with HIV in the public primary care service in Cape Town, South Africa. Tropical Medicine & International Health, 16 (11):1384-1399en_US
dc.identifier.urihttp://hdl.handle.net/10566/261
dc.language.isoenen_US
dc.privacy.showsubmitterfalse
dc.publisherWiley-Blackwellen_US
dc.rightsThis is the author pre-print of an article published by Wiley-Blackwell. It is released here under a Creative Commons Attribution licence.
dc.source.urihttp://dx.doi.org/10.1111/j.1365-3156.2011.02842.x
dc.status.ispeerreviewedtrue
dc.subjectHIVen_US
dc.subjectProgramme evaluationen_US
dc.subjectPositive preventionen_US
dc.subjectContinuity of patient careen_US
dc.subjectNon-ART care of HIV clientsen_US
dc.titleBetween HIV diagnosis and initiation of antiretroviral therapy: Assessing the effectiveness of care for people living with HIV in the public primary care service in Cape Town, South Africaen_US
dc.typePreprinten_US

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Research Articles (Research in HIV and AIDS)
Dr. Vera Scott (School of Public Health)