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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Non-enrollment for free community HIV care: findings from a population-based study in Rakai, Uganda</title><author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Makumbi, Fredrick" sort="Makumbi, Fredrick" uniqKey="Makumbi F" first="Fredrick" last="Makumbi">Fredrick Makumbi</name><affiliation><nlm:aff id="A2">Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Reynolds, Steven" sort="Reynolds, Steven" uniqKey="Reynolds S" first="Steven" last="Reynolds">Steven Reynolds</name><affiliation><nlm:aff id="A3">National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA</nlm:aff></affiliation></author><author><name sortKey="Galiwango, Ronald" sort="Galiwango, Ronald" uniqKey="Galiwango R" first="Ronald" last="Galiwango">Ronald Galiwango</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Kagaayi, Joseph" sort="Kagaayi, Joseph" uniqKey="Kagaayi J" first="Joseph" last="Kagaayi">Joseph Kagaayi</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Nalugoda, Fred" sort="Nalugoda, Fred" uniqKey="Nalugoda F" first="Fred" last="Nalugoda">Fred Nalugoda</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Ssettuba, Absalom" sort="Ssettuba, Absalom" uniqKey="Ssettuba A" first="Absalom" last="Ssettuba">Absalom Ssettuba</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Sekasanvu, Joseph" sort="Sekasanvu, Joseph" uniqKey="Sekasanvu J" first="Joseph" last="Sekasanvu">Joseph Sekasanvu</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Musuuza, Jackson" sort="Musuuza, Jackson" uniqKey="Musuuza J" first="Jackson" last="Musuuza">Jackson Musuuza</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Serwada, David" sort="Serwada, David" uniqKey="Serwada D" first="David" last="Serwada">David Serwada</name><affiliation><nlm:aff id="A2">Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Gray, Ron" sort="Gray, Ron" uniqKey="Gray R" first="Ron" last="Gray">Ron Gray</name><affiliation><nlm:aff id="A4">Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA</nlm:aff></affiliation></author><author><name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name><affiliation><nlm:aff id="A4">Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21293989</idno><idno type="pmc">3722430</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722430</idno><idno type="RBID">PMC:3722430</idno><idno type="doi">10.1080/09540121.2010.525614</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">001D85</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001D85</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Non-enrollment for free community HIV care: findings from a population-based study in Rakai, Uganda</title><author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Makumbi, Fredrick" sort="Makumbi, Fredrick" uniqKey="Makumbi F" first="Fredrick" last="Makumbi">Fredrick Makumbi</name><affiliation><nlm:aff id="A2">Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Reynolds, Steven" sort="Reynolds, Steven" uniqKey="Reynolds S" first="Steven" last="Reynolds">Steven Reynolds</name><affiliation><nlm:aff id="A3">National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA</nlm:aff></affiliation></author><author><name sortKey="Galiwango, Ronald" sort="Galiwango, Ronald" uniqKey="Galiwango R" first="Ronald" last="Galiwango">Ronald Galiwango</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Kagaayi, Joseph" sort="Kagaayi, Joseph" uniqKey="Kagaayi J" first="Joseph" last="Kagaayi">Joseph Kagaayi</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Nalugoda, Fred" sort="Nalugoda, Fred" uniqKey="Nalugoda F" first="Fred" last="Nalugoda">Fred Nalugoda</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Ssettuba, Absalom" sort="Ssettuba, Absalom" uniqKey="Ssettuba A" first="Absalom" last="Ssettuba">Absalom Ssettuba</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Sekasanvu, Joseph" sort="Sekasanvu, Joseph" uniqKey="Sekasanvu J" first="Joseph" last="Sekasanvu">Joseph Sekasanvu</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Musuuza, Jackson" sort="Musuuza, Jackson" uniqKey="Musuuza J" first="Jackson" last="Musuuza">Jackson Musuuza</name><affiliation><nlm:aff id="A1">Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</nlm:aff></affiliation></author><author><name sortKey="Serwada, David" sort="Serwada, David" uniqKey="Serwada D" first="David" last="Serwada">David Serwada</name><affiliation><nlm:aff id="A2">Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Gray, Ron" sort="Gray, Ron" uniqKey="Gray R" first="Ron" last="Gray">Ron Gray</name><affiliation><nlm:aff id="A4">Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA</nlm:aff></affiliation></author><author><name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name><affiliation><nlm:aff id="A4">Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA</nlm:aff></affiliation></author></analytic><series><title level="j">AIDS care</title><idno type="ISSN">0954-0121</idno><idno type="eISSN">1360-0451</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">Improved understanding of HIV-related health-seeking behavior at a population level is important in informing the design of more effective HIV prevention and care strategies. We assessed the frequency and determinants of failure to seek free HIV care in Rakai, Uganda. HIV-positive participants in a community cohort who accepted VCT were referred for free HIV care (cotrimoxazole prophylaxis, CD4 monitoring, treatment of opportunistic infections, and, when indicated, antiretroviral therapy). We estimated proportion and adjusted Prevalence Risk Ratios (adj. PRR) of non-enrollment into care six months after receipt of VCT using log-binomial regression. About 1145 HIV-positive participants in the Rakai Community Cohort Study accepted VCT and were referred for care. However, 31.5% (361/1145) did not enroll into HIV care six months after referral. Non-enrollment was significantly higher among men (38%) compared to women (29%, <italic>p</italic>=0.005). Other factors associated with non-enrollment included: younger age (15–24 years, adj. PRR=2.22; 95% CI: 1.64, 3.00), living alone (adj. PRR=2.22; 95% CI: 1.57, 3.15); or in households with 1–2 co-residents (adj. PRR=1.63; 95% CI: 1.31, 2.03) compared to three or more co-residents, or a CD4 count >250 cells/ul (adj. PRR=1.81; 95% CI: 1.38, 2.46). Median (IQR) CD4 count was lower among enrolled 388 cells/ul (IQR: 211,589) compared to those not enrolled 509 cells/ul (IQR: 321,754).</p><p id="P2">About one-third of HIV-positive persons failed to utilize community-based free services. Non-use of services was greatest among men, the young, persons with higher CD4 counts and the more socially isolated, suggesting a need for targeted strategies to enhance service uptake.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8915313</journal-id><journal-id journal-id-type="pubmed-jr-id">1056</journal-id><journal-id journal-id-type="nlm-ta">AIDS Care</journal-id><journal-id journal-id-type="iso-abbrev">AIDS Care</journal-id><journal-title-group><journal-title>AIDS care</journal-title></journal-title-group><issn pub-type="ppub">0954-0121</issn><issn pub-type="epub">1360-0451</issn></journal-meta><article-meta><article-id pub-id-type="pmid">21293989</article-id><article-id pub-id-type="pmc">3722430</article-id><article-id pub-id-type="doi">10.1080/09540121.2010.525614</article-id><article-id pub-id-type="manuscript">NIHMS492783</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Non-enrollment for free community HIV care: findings from a population-based study in Rakai, Uganda</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nakigozi</surname><given-names>Gertrude</given-names></name><xref ref-type="aff" rid="A1">a</xref><xref ref-type="corresp" rid="CR1">*</xref></contrib><contrib contrib-type="author"><name><surname>Makumbi</surname><given-names>Fredrick</given-names></name><xref ref-type="aff" rid="A2">b</xref></contrib><contrib contrib-type="author"><name><surname>Reynolds</surname><given-names>Steven</given-names></name><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Galiwango</surname><given-names>Ronald</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Kagaayi</surname><given-names>Joseph</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Nalugoda</surname><given-names>Fred</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Ssettuba</surname><given-names>Absalom</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Sekasanvu</surname><given-names>Joseph</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Musuuza</surname><given-names>Jackson</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Serwada</surname><given-names>David</given-names></name><xref ref-type="aff" rid="A2">b</xref></contrib><contrib contrib-type="author"><name><surname>Gray</surname><given-names>Ron</given-names></name><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Wawer</surname><given-names>Maria</given-names></name><xref ref-type="aff" rid="A4">d</xref></contrib></contrib-group><aff id="A1"><label>a</label>Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Rakai, Uganda</aff><aff id="A2"><label>b</label>Makerere University School of Public Health, Kampala, Uganda</aff><aff id="A3"><label>c</label>National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA</aff><aff id="A4"><label>d</label>Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA</aff><author-notes><corresp id="CR1"><label>*</label>Corresponding author. <email>gnakigozi@rhsp.org</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>9</day><month>7</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>25</day><month>7</month><year>2013</year></pub-date><volume>23</volume><issue>6</issue><fpage>764</fpage><lpage>770</lpage><permissions><copyright-statement>© 2011 Taylor & Francis</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><p id="P1">Improved understanding of HIV-related health-seeking behavior at a population level is important in informing the design of more effective HIV prevention and care strategies. We assessed the frequency and determinants of failure to seek free HIV care in Rakai, Uganda. HIV-positive participants in a community cohort who accepted VCT were referred for free HIV care (cotrimoxazole prophylaxis, CD4 monitoring, treatment of opportunistic infections, and, when indicated, antiretroviral therapy). We estimated proportion and adjusted Prevalence Risk Ratios (adj. PRR) of non-enrollment into care six months after receipt of VCT using log-binomial regression. About 1145 HIV-positive participants in the Rakai Community Cohort Study accepted VCT and were referred for care. However, 31.5% (361/1145) did not enroll into HIV care six months after referral. Non-enrollment was significantly higher among men (38%) compared to women (29%, <italic>p</italic>=0.005). Other factors associated with non-enrollment included: younger age (15–24 years, adj. PRR=2.22; 95% CI: 1.64, 3.00), living alone (adj. PRR=2.22; 95% CI: 1.57, 3.15); or in households with 1–2 co-residents (adj. PRR=1.63; 95% CI: 1.31, 2.03) compared to three or more co-residents, or a CD4 count >250 cells/ul (adj. PRR=1.81; 95% CI: 1.38, 2.46). Median (IQR) CD4 count was lower among enrolled 388 cells/ul (IQR: 211,589) compared to those not enrolled 509 cells/ul (IQR: 321,754).</p><p id="P2">About one-third of HIV-positive persons failed to utilize community-based free services. Non-use of services was greatest among men, the young, persons with higher CD4 counts and the more socially isolated, suggesting a need for targeted strategies to enhance service uptake.</p></abstract><kwd-group><kwd>HIV</kwd><kwd>HIV care</kwd><kwd>enrollment</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID</funding-source><award-id>Z99 AI999999 || AI</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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