International Journal of STD and AIDS
Volume 20, Issue 12, 2009, Pages 858-862

Good treatment outcomes among foreigners receiving antiretroviral therapy in Johannesburg, South Africa (Article)

McCarthy K.* , Chersich M.F. , Vearey J. , Meyer-Rath G. , Jaffer A. , Simpwalo S. , Venter W.D.F.
  • a Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
  • b Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa, Department of Obstetrics and Gynaecology, University of Gent, Gent, Belgium
  • c Forced Migration Studies Programme, University of the Witwatersrand, Johannesburg, South Africa
  • d London School of Hygiene and Tropical Medicine, London, United Kingdom
  • e Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
  • f Nazareth House, Johannesburg, South Africa
  • g Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Foreigners, including displaced persons, often have limited health-care access, especially to HIV services. Outcomes of antiretroviral therapy (ART) in South Africans and foreigners were compared at a Johannesburg non-governmental clinic. Records were reviewed of 1297 adults enrolled between April 2004 and March 2007 (568 self-identified foreigners, 431 South Africans citizens and 298 with unknown origin). Compared with citizens, foreigners had fewer hospital admissions (39%, 90/303 versus 51%, 126/244; P< 0.001), less missed appointments for ART initiation (20%, 39/200 versus 25%, 51/206; P< 0.001), faster median time to ART initiation (14 versus 21 days, P = 0.008), better retention in care (88%, 325/369 versus 69%, 155/226; P< 0.001) and lower mortality (2.5%, 14/568 versus 10%, 44/431; P< 0.001) after 426 person-years. In logistic regression, after controlling for baseline CD4 count and tuberculosis status, foreigners were 55% less likely to fail ART than citizens (95% CI = 0.23-0.87). These findings support United Nations High Commissioner for Refugees recommendations that ART should not be withheld from displaced persons.

Author Keywords

UNHCR South Africa Antiretroviral therapy Refugees HIV

Index Keywords

medical record review hospital admission HIV Infections unspecified side effect Human immunodeficiency virus infection drug treatment failure human sex difference stavudine controlled study priority journal United Nations Medical Audit South Africa Young Adult foreign worker Humans Adolescent Treatment Outcome male Emigrants and Immigrants CD4 lymphocyte count female tuberculosis Ambulatory Care Facilities Article major clinical study adult HIV-1 lamivudine health care access cohort analysis efavirenz mortality Health Services Accessibility Anti-HIV Agents antiviral therapy
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-74049144051&doi=10.1258%2fijsa.2009.009258&partnerID=40&md5=dc020e71a8060b455bcfc391e9e055a2
DOI: 10.1258/ijsa.2009.009258
ISSN: 09564624
Cited by: 22
Original Language: English