학술논문

Built Environment and HIV Linkage to Care in Rural South Africa
Document Type
article
Source
Community Health Equity Research & Policy. 43(2)
Subject
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
Language
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.