South Africa: Detailed demographic, HIV surveillance and GIS data were used to estimate the proportion of HIV positive adults accessing antiretroviral treatment (ART) within northern KwaZulu-Natal, South Africa. The reality of antiretroviral roll-out through primary care has differed from that anticipated; and real world data is needed to further scale up the services.
Demographic, spatial and socioeconomic factors influencing the likelihood of individuals accessing antiretroviral treatment were explored using multivariable analysis.
The analysis found that mean uptake of ART among HIV positive resident adults was 21per cent (95per cent CI 20.1-21.9). Uptake among HIV positive men (19.2per cent) was slightly lower than women (21.8per cent, P=0.011). An individual’s likelihood of accessing ART was not associated with level of education, household assets or urban/rural locale.
ART uptake was not associated with distance from the nearest primary healthcare facility (aOR=0.728 per square-root transformed km, 95per cent CI 0.658-0.963, P=0.002).
Despite concerns about the equitable nature of antiretroviral treatment rollout, researchers found very few differences in ART uptake across a range of socio-demographic variables in a rural South African population. However, even when socio-demographic factors were taken into account, individuals living far away from primary healthcare clinics were still not accessing ART.
The research was published in BMC Public Health 2010. The complete article is available as a provisional PDF.
Source: BMC Public Health