Open AccessLoss to Follow-Up from HIV Screening to ART Initiation in Rural China
Author(s) -
Diane Yu Gu,
Yurong Mao,
Zhenzhu Tang,
Julio S. G. Montaner,
Zhiyong Shen,
Qingqing Zhu,
Roger Detels,
Xingming Jin,
Ranhua Xiong,
Jing Xu,
Walter Ling,
Lynda Erinoff,
Robert Lindblad,
David Liu,
Paul Van Veldhuisen,
Albert Hasson,
Zunyou Wu
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0164346
Subject(s) - medicine , psychological intervention , human immunodeficiency virus (hiv) , hiv screening , family medicine , confidence interval , pediatrics , nursing , men who have sex with men , syphilis
Background Patients who are newly screened HIV positive by EIA are lost to follow-up due to complicated HIV testing procedures. Because this is the first step in care, it affects the entire continuum of care. This is a particular concern in rural China. Objective(s) To assess the routine HIV testing completeness and treatment initiation rates at 18 county-level general hospitals in rural Guangxi. Methods We reviewed original hospital HIV screening records. Investigators also engaged with hospital leaders and key personnel involved in HIV prevention activities to characterize in detail the routine care practices in place at each county. Results 699 newly screened HIV-positive patients between January 1 and June 30, 2013 across the 18 hospitals were included in the study. The proportion of confirmatory testing across the 18 hospitals ranged from 14% to 87% (mean of 43%), and the proportion of newly diagnosed individuals successfully initiated antiretroviral treatment across the hospitals ranged from 3% to 67% (mean of 23%). The average interval within hospitals for individuals to receive the Western Blot (WB) and CD4 test results from HIV positive screening (i.e. achieving testing completion) ranged from 14–116 days (mean of 41.7 days) across the hospitals. The shortest interval from receiving a positive EIA screening test result to receiving WB and CD4 testing and counseling was 0 day and the longest was 260 days. Conclusion The proportion of patients newly screened HIV positive that completed the necessary testing procedures for HIV confirmation and received ART was very low. Interventions are urgently needed to remove barriers so that HIV patients can have timely access to HIV/AIDS treatment and care in rural China.