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10.11.2018 | Original Paper Open Access

Understanding the Time Needed to Link to Care and Start ART in Seven HPTN 071 (PopART) Study Communities in Zambia and South Africa

AIDS and Behavior
Janet Seeley, Virginia Bond, Blia Yang, Sian Floyd, David MacLeod, Lario Viljoen, Mwelwa Phiri, Melvin Simuyaba, Graeme Hoddinott, Kwame Shanaube, Chiti Bwalya, Laing de Villiers, Karen Jennings, Margaret Mwanza, Ab Schaap, Rory Dunbar, Kalpana Sabapathy, Helen Ayles, Peter Bock, Richard Hayes, Sarah Fidler, the HPTN 071 (PopART) study team
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10461-018-2335-7) contains supplementary material, which is available to authorized users.


To achieve UNAIDS 90:90:90 targets at population-level, knowledge of HIV status must be followed by timely linkage to care, initiation and maintenance of antiretroviral therapy (ART) for all people living with HIV (PLHIV). Interpreting quantitative patterns using qualitative data, we investigate time taken to link to care and initiate ART amongst individuals aware of their HIV-status in high HIV-prevalence urban communities in the HPTN 071 (PopART) study, a community-randomised trial of a combination HIV prevention package, including universal testing and treatment, in 21 communities in Zambia and South Africa. Data are drawn from the seven intervention communities where immediate ART irrespective if CD4 count was offered from the trial-start in 2014. Median time from HIV-diagnosis to ART initiation reduced after 2 years of delivering the intervention from 10 to 6 months in both countries but varied by gender and community of residence. Social and health system realities impact decisions made by PLHIV about ART initiation.

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