CitationShangase, Nosipho; Pence, Brian W.; Lippman, Sheri A.; Dufour, Mi-Suk Kang; Kabudula, Chodziwadziwa Whiteson; Gómez-Olivé, F. Xavier; Kahn, Kathleen; & Pettifor, Audrey E. (Online ahead of print). Built Environment and HIV Linkage to Care in Rural South Africa. International Quarterly of Community Health Education.
AbstractBACKGROUND: We assessed built environment (residential density, landuse mix and aesthetics) and HIV linkage to care (LTC) among 1,681 (18-49 years-old) residents of 15 Mpumalanga villages, South Africa.
METHODS: Multilevel models (linear-binomial) were used for the association between built environment, measured using NEWS for Africa, and LTC from a clinical database of 9 facilities (2015-2018). Additionally, we assessed effect-measure modification by universal test-and-treat policy (UTT).
RESULTS: We observed, a significant association in the adjusted 3-month probability of LTC for residential density (risk difference (RD)%: 5.6, 95%CI: 1.2-10.1), however, no association for land-use mix (RD%: 2.4, 95%CI: -0.4, 5.2) and aesthetics (RD%: -1.2, 95%CI: -4.5-2.2). Among those diagnosed after UTT, residents of high land-use villages were more likely to link-to-care than those of low land-use villages at 12 months (RD%: 4.6, 95%CI: 1.1-8.1, p < 0.04), however, not at 3 months (RD%: 3.0, 95%CI: -2.1-8.0, p > 0.10).
CONCLUSION: Findings suggest, better built environment conditions (adequate infrastructure, proximity to services etc.) help facilitate LTC. Moreover, UTT appears to have a protective effect on LTC.
Reference TypeJournal Article
Year PublishedOnline ahead of print
Journal TitleInternational Quarterly of Community Health Education
Pence, Brian W.
Lippman, Sheri A.
Dufour, Mi-Suk Kang
Kabudula, Chodziwadziwa Whiteson
Gómez-Olivé, F. Xavier
Pettifor, Audrey E.