1. Built Environment and HIV Linkage to Care in Rural South Africa
- Author
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Shangase, Nosipho, Pence, Brian, Lippman, Sheri A, Dufour, Mi-Suk Kang, Kabudula, Chodziwadziwa Whiteson, Gómez-Olivé, F Xavier, Kahn, Kathleen, and Pettifor, Audrey
- Subjects
Public Health ,Health Sciences ,Social Determinants of Health ,Women's Health ,Sexually Transmitted Infections ,Infectious Diseases ,Clinical Research ,HIV/AIDS ,Prevention ,Life on Land ,Humans ,Adolescent ,Young Adult ,Adult ,Middle Aged ,HIV Infections ,South Africa ,Rural Population ,Built Environment ,HIV linkage to care ,Agincourt Health and Demographic Surveillance System ,built environment ,universal test and treat ,Public health ,Policy and administration - Abstract
BackgroundWe assessed built environment (residential density, landuse mix and aesthetics) and HIV linkage to care (LTC) among 1,681 (18-49 years-old) residents of 15 Mpumalanga villages, South Africa.MethodsMultilevel models (linear-binomial) were used for the association between built environment, measured using NEWS for Africa, and LTC from a clinical database of 9 facilities (2015-2018). Additionally, we assessed effect-measure modification by universal test-and-treat policy (UTT).ResultsWe observed, a significant association in the adjusted 3-month probability of LTC for residential density (risk difference (RD)%: 5.6, 95%CI: 1.2-10.1), however, no association for land-use mix (RD%: 2.4, 95%CI: -0.4, 5.2) and aesthetics (RD%: -1.2, 95%CI: -4.5-2.2). Among those diagnosed after UTT, residents of high land-use villages were more likely to link-to-care than those of low land-use villages at 12 months (RD%: 4.6, 95%CI: 1.1-8.1, p 0.10).ConclusionFindings suggest, better built environment conditions (adequate infrastructure, proximity to services etc.) help facilitate LTC. Moreover, UTT appears to have a protective effect on LTC.
- Published
- 2023