Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya

Abstract

Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18-25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrollment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.

Conflict of interest statement

Conflicts of interest We wish to declare a potential perceived conflict of interest and the measures taken to ensure this has not influenced our findings. Funding for this study was provided by the HIV counseling and testing (HCT) campaign implementer, Vestergaard Frandsen. The sponsor did not have any role in the study design, analysis or interpretation of the data. However, as is good practice in implementation science, two authors from Vestergaard Frandsen (L.K. and A.D) were included in the final review of the manuscript to ensure accurate presentation of the HCT campaign and the study setting.

Figures

Fig. 1

Time to linkage following HIV testing for those receiving and not receiving a PLHA navigator home visit, by sex