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Table 3 Study outcomes of clients who received CommLink and peer-delivered standard linkage services, Manzini region, Eswatini, March 2016 – April 2020

From: Antiretroviral therapy initiation and retention among clients who received peer-delivered linkage case management and standard linkage services, Eswatini, 2016–2020: retrospective comparative cohort study

 

Unadjusted

Adjusteda

Outcomes

CommLink

n (%)

SLS

n (%)

CommLink

% (95% CI)

SLS

% (95% CI)

RR (95% CI)

p-value

ART initiationb

n = 773

n = 769

    

 7 days

486 (62.9)

192 (25.0)

61.9 (56.6, 67.8)

23.9 (18.8, 30.5)

2.59 (1.98, 3.38)

 < 0.0001

 30 days

644 (83.3)

264 (34.3)

80.1 (76.7, 83.5)

32.7 (27.0, 39.5)

2.45 (1.99, 3.01)

 < 0.0001

 90 days

699 (90.4)

302 (39.3)

88.4 (86.6, 90.1)

37.9 (32.1, 44.7)

2.33 (1.97, 2.77)

 < 0.0001

 Everc

749 (96.9)

499 (64.9)

96.6 (95.6, 97.7)

64.3 (57.2, 72.4)

1.50 (1.33, 1.70)

 < 0.0001

Transfer ART cared

n = 749

n = 499

    

 Everc

123 (16.4)

75 (15.0)

17.3 (15.6, 19.3)

14.6 (13.1, 16.3)

1.19 (1.02, 1.38)

0.0280

ART retentiona,e

n = 749

n = 499

    

 6 months

(93.2)

(94.5)

93.4 (92.2, 94.6)

95.0 (93.5, 96.4)

0.98 (0.97, 0.999)

0.0328

 12 months

(89.7)

(91.7)

89.9 (88.3, 91.5)

92.3 (90.3, 94.3)

0.97 (0.95, 0.998)

0.0338

 18 months

(86.9)

(89.4)

87.1 (85.1, 89.1)

90.2 (87.7, 92.6)

0.97 (0.93, 0.998)

0.0343

 24 months

(84.5)

(87.5)

84.8 (82.5, 87.0)

88.3 (85.6, 91.1)

0.96 (0.92, 0.997)

0.0346

Viral suppressionf

n = 566

n = 359

    

 Ever

546 (96.5)

347 (96.7)

95.2 (94.7, 95.7)

96.7 (95.9, 97.6)

0.98 (0.98, 0.99)

0.0004

 Last test

536 (94.7)

343 (95.5)

93.7 (92.2, 95.2)

95.4 (94.0, 96.9)

0.98 (0.97, 0.99)

0.0019

ART initiated and retainedb

n = 773

n = 769

    

 6 months

650 (84.1)

308 (40.1)

80.2 (77.0, 83.6)

38.4 (33.4, 44.1)

2.09 (1.78, 2.45)

 < 0.0001

 12 months

630 (81.5)

362 (47.1)

79.0 (76.4, 81.8)

46.0 (40.4, 52.4)

1.72 (1.49, 1.98)

 < 0.0001

 18 months

612 (79.2)

388 (50.5)

76.3 (73.0, 79.7)

49.5 (44.0, 55.7)

1.54 (1.33, 1.79)

 < 0.0001

Other

n = 773

n = 769

    

 Deceasedg

22 (2.8)

14 (1.8)

2.4 (1.6, 3.8)

1.7 (0.8, 3.5)

1.44 (0.92, 2.27)

0.1111

 Lost to follow-up

173 (22.4)

331 (43.0)

22.8 (18.8, 27.7)

42.5 (38.8, 46.5)

0.54 (0.42, 0.69)

 < 0.0001

  1. SLS peer-delivered standard linkage services, ART antiretroviral therapy, RR relative risk, CI confidence interval, Tinkhundla regional geopolitical subdivisions of Eswatini
  2. aEstimated using generalized estimating equations (GEE) models with a log link (SAS 9.4), excluding ART retention; ART retention and relative risks were estimated with accelerated failure-time parametric survival models using STATA STREG postestimation commands, censoring lost-to-follow-up clients on their last antiretroviral appointment date; GEE and parametric survival models adjusted for age group, sex, urban or rural area of HIV diagnosis, and within-Tinkhundla clustering
  3. bAfter date of HIV diagnosis among all CommLink and SLS clients
  4. cMedian follow-up period 961 days (interquartile range 827—1093)
  5. dReceipt of ART at ≥ 1 different healthcare facilities in Eswatini after ART initiation
  6. eAmong clients initiated on ART, retained is defined as not being more than 90 days late for the last antiretroviral refill appointment
  7. fAmong clients initiated on ART who had at least one documented viral load test: 566 (75.6%) CommLink and 359 (71.9%) SLS ART-initiated clients had at least one documented viral load test
  8. gDocumented in HIV medical chart or reported by family members upon tracing
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