Comparison of knowledge of HIV status and treatment coverage between non-citizens and citizens: Botswana Combination Prevention Project (BCPP)

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Marukutira, Tafireyi ; Block, Lisa ; Alwano, Mary Grace ; Behel, Stephanie ; Jarvis, Joseph N. ; Chakalisa, Unoda ; Powis, Kate ; Novitsky, Vladimir ; Bapati, William ; Wang, Huisheng ; Ussery, Faith ; Lebelonyane, Refeletswe ; Mills, Lisa A. ; Moore, Janet ; Bachanas, Pamela
• Description:
  Introduction
  
  Non-citizens often face barriers to HIV care and treatment. Quantifying knowledge of positive HIV status and antiretroviral therapy (ART) coverage among non-citizens in a high HIV-prevalence country like Botswana that is close to achieving UNAIDS “90-90-90” targets may expose important gaps in achieving universal HIV testing and treatment.
  
  Methods
  
  The Botswana Combination Prevention Project (BCPP) is a pair-matched cluster-randomized trial evaluating the impact of prevention interventions on HIV incidence in 30 rural or peri-urban communities. Community case finding and HIV testing were conducted in home and mobile venues in 15 intervention communities from October 2013-September 2017. In this secondary analysis, we compared HIV positivity, knowledge of positive HIV-status, and ART status among all citizens and non-citizens assessed at intake in the intervention communities.
  
  Results
  
  HIV status was assessed in 57,556 residents in the intervention communities; 4% (n = 2,463) were non-citizens. Five communities accounted for 81% of the total non-citizens assessed. A lower proportion of non-citizens were HIV-positive (15%; n = 369) compared to citizens (21%; n = 11,416) [p = 0.026]; however, a larger proportion of non-citizens did not know their HIV-positive status prior to BCPP testing (75%) as compared to citizens (15%) [p = 0.003]. Among residents with knowledge of their HIV-positive status before BCPP, 79% of the non-citizens (72/91) were on ART compared to 86% (8,267/9,652) of citizens (p = 0.137).
  
  Conclusions
  
  Although non-citizens were less likely to know their HIV-positive status compared to citizens, there were no differences in treatment uptake among non-citizens and citizens who knew their status. Designing interventions for non-citizens that provide HIV testing and treatment services commensurate to that of citizens as well as targeting communities with the largest number of non-citizens may help close a meaningful gap in the HIV care cascade and ensure ethical treatment for all HIV-positive persons.
  
  Trial registration
  
  ClinicalTrials.gov: NCT01965470 (Botswana Combination Prevention Project).
  
  
• Subjects:
  Adolescent Adult Antiretroviral Therapy, Highly Active Female Healthcare Disparities Health Knowledge, Attitudes, Practice HIV Infections Humans Male Middle Aged Outcome Assessment, Health Care Public Health Surveillance Residence Characteristics Young Adult

  More +
• Source:
  PLoS One. 14(8)
• Pubmed ID:
  31465494
• Pubmed Central ID:
  PMC6715216
• Document Type:
  Journal Article
• Funding:
  U01 GH000447/GH/CGH CDC HHS/United States ; U2G GH001911/GH/CGH CDC HHS/United States
• Place as Subject:
  Botswana
• Location:
  Africa
• Volume:
  14
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d5c0e702cc248a33cf01f4bb017ac50326ff4ea41c308ca0dc79eb90ee71a174
• Download URL:
  https://stacks.cdc.gov/view/cdc/82523/cdc_82523_DS1.pdf
• File Type:
  [PDF - 365.33 KB ]