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Change of treatment guidelines and evolution of ART initiation in rural South Africa: data of a large HIV care and treatment programme

Overview of attention for article published in BMC Infectious Diseases, October 2015
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Title
Change of treatment guidelines and evolution of ART initiation in rural South Africa: data of a large HIV care and treatment programme
Published in
BMC Infectious Diseases, October 2015
DOI 10.1186/s12879-015-1207-2
Pubmed ID
Authors

Mélanie PLAZY, François DABIS, Kevindra NAIDU, Joanna ORNE-GLIEMANN, Till BARNIGHAUSEN, Rosemary DRAY-SPIRA

Abstract

While WHO recommendations are to treat people earlier and earlier, it will considerably increase the number of HIV infected people eligible for antiretroviral therapy (ART). In South Africa, a country which carries one of the highest HIV burden worldwide, very few studies are available on the impact of the ART guidelines on time to ART initiation in both individuals with low CD4 count and those newly eligible for ART. We thus aimed to describe ART initiation percentages in a large HIV programme in rural KwaZulu-Natal, South Africa, according to the temporal changes of national ART eligibility guidelines from 2007 to 2012. Adults who accessed the decentralized Hlabisa HIV treatment programme in 2007-2012 were included. Three periods following the temporal change of ART eligibility guidelines were defined (Period 1: until April 2010; Period 2: April 2010 - July 2011; Period 3: from August 2011). Percentages of ART initiation within three months of programme entry were estimated in men, in women of childbearing age (<40 years old) and in older women, and stratifying by CD4 count. Trend tests and logistic regression models were used to study the effects of change of guidelines on ART initiation percentages. In individuals with CD4 count ≤200 cells/μL (N = 5709 men, N = 6743 women <40 years old and N = 2017 older women), percentages of ART initiation did not differ over time (p trend = 0.25; 0.28; and 0.14, respectively). In individuals with CD4 count = 201-350 cells/μL (N = 2680 men, N = 6086 women <40 years old and N = 1415 older women), percentages of ART initiation significantly increased over time (p trend <0.01 for the three groups): from 6 % in Period 1 to 20 % in Period 2 to 40 % in Period 3 in women of childbearing age, and from 7 % to 8-10 % to 42 % in men and in older women. As temporal changes of guidelines, percentages of ART initiation significantly increased in newly ART eligible people and did not decrease in individuals with very low CD4 counts. It will be crucial to continue verifying the evolution of these percentages of ART initiation with future recommendations reaching near-to-universal access to ART, to ensure that individuals most in need of ART receive it.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 2%
Unknown 63 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 15 23%
Student > Ph. D. Student 11 17%
Student > Master 8 13%
Student > Doctoral Student 5 8%
Student > Bachelor 4 6%
Other 14 22%
Unknown 7 11%
Readers by discipline Count As %
Medicine and Dentistry 28 44%
Nursing and Health Professions 9 14%
Social Sciences 6 9%
Agricultural and Biological Sciences 3 5%
Computer Science 1 2%
Other 6 9%
Unknown 11 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 October 2015.
All research outputs
#18,429,829
of 22,831,537 outputs
Outputs from BMC Infectious Diseases
#5,602
of 7,678 outputs
Outputs of similar age
#204,669
of 284,375 outputs
Outputs of similar age from BMC Infectious Diseases
#130
of 166 outputs
Altmetric has tracked 22,831,537 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,678 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 284,375 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 166 others from the same source and published within six weeks on either side of this one. This one is in the 3rd percentile – i.e., 3% of its contemporaries scored the same or lower than it.