HIV prevalence and the cascade of care in five South African correctional facilities

• Published in: PloS one Vol. 15; no. 7; p. e0235178
• Main Authors: Stevenson, Kelsey A, Podewils, Laura J, Zishiri, Vincent K, Castro, Kenneth G, Charalambous, Salome
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 02.07.2020; Public Library of Science (PLoS)
• Subjects: Antiretroviral therapy; Biology and Life Sciences; Care and treatment; Clustering; Confidence intervals; Correctional institutions; Data collection; Epidemics; Health aspects; Health risks; HIV; HIV infections; Human immunodeficiency virus; Imprisonment; Infections; Laboratories; Medical diagnosis; Medical tests; Medicine and Health Sciences; Patients; People and places; Poisson density functions; Prisoners; Prisons; Public health; Regression analysis; Risk groups; Robustness (mathematics); Screening; Statistical analysis; Statistics; Tuberculosis; Variables; South Africa; Atlanta Georgia; Georgia; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0235178

South Africa is home to the world's largest HIV epidemic. Throughout the world, incarcerated individuals have a higher prevalence of HIV than the general public, and South Africa has one of the highest rates of incarceration in sub-Saharan Africa. In spite of this, little has been published about the burden of HIV and how care is delivered in South African correctional facilities. To estimate the prevalence of people living with HIV and identify initiation and retention in the HIV cascade of care across five correctional facilities. Cross-sectional retrospective analysis of 30,571 adult inmates who participated in a tuberculosis screening and HIV counseling and testing campaign in South African correctional facilities (January 1, 2014-January 31, 2015). Descriptive statistics were used to estimate the proportion and 95% confidence intervals of HIV. Proportions of persons retained and lost at each step in the HIV cascade of care under this intervention were calculated. Poisson regression with robust variance estimates were used, and clustering by facility was accounted for in all analyses. In this setting, routine screening is recommended, and measures are needed to ensure that persons diagnosed are adequately linked to and retained in care.