1. Built Environment and HIV Linkage to Care in Rural South Africa.
- Author
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Shangase, Nosipho, Shangase, Nosipho, Pence, Brian, Lippman, Sheri A, Dufour, Mi-Suk Kang, Kabudula, Chodziwadziwa Whiteson, Gómez-Olivé, F Xavier, Kahn, Kathleen, Pettifor, Audrey, Shangase, Nosipho, Shangase, Nosipho, Pence, Brian, Lippman, Sheri A, Dufour, Mi-Suk Kang, Kabudula, Chodziwadziwa Whiteson, Gómez-Olivé, F Xavier, Kahn, Kathleen, and Pettifor, Audrey
- 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 < 0.04), however, not at 3 months (RD%: 3.0, 95%CI: -2.1-8.0, 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