Clinic attendance by sex and HIV status in rural South Africa
BACKGROUND: HIV-negative men are over-represented in tuberculosis (TB) prevalence surveys. Traditionally, TB screening is focused in clinics. We aimed to determine the frequency of primary healthcare clinic (PHC) attendance among HIV-negative men in a TB-prevalent setting.
METHODS: Since January 2017, PHC attendees in a rural South African demographic surveillance area (DSA) were asked their reason for attendance. HIV status was defined as positive if tested positive in a DSA sero-survey or attended clinic for HIV care; negative if tested negative between January 2014-December 2017 and no HIV-related visits; and HIV-unknown otherwise.
RESULTS: Among 67124 DSA residents (=15 years), 27038 (40%) were male; 14196 (21%) were classified HIV-positive, 18892 (28%) HIV-negative and 34036 (51%) HIV-unknown. Between April 2017 and March 2018, 24382/67124 (36.3%, 95% confidence interval [CI] 36.0-36.7) adults made =1 PHC visit, comprising 9805/40086 (24.5%, 95%CI 23.6-25.3) of HIV-negative or unknown women and 3440/27038 (12.7%, 95%CI 11.6-13.8) of HIV-negative or unknown men. Overall, HIV care accounted for 37556/88109 (43.6%) of adult PHC visits.
CONCLUSION: In this rural population, HIV-negative and -unknown men rarely attend PHCs. Improving TB screening in clinics may not reach a key population with respect to undiagnosed TB. Additional strategies are needed to diagnose and treat TB earlier.
Keywords
Tuberculosis; Adults; Rural population; Africa; Mass screening; Primary Health Care; Tuberculosis case finding; HIV infectionItem Type | Dataset |
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Resource Type |
Resource Type Resource Description Dataset Quantitative |
Capture method | Unknown |
Collection Period |
From To 1 April 2017 31 March 2018 |
Date | 25 May 2021 |
Language(s) of written materials | English |
Creator(s) |
Randera-Rees, S, Safari, WC, Gareta, D, Herbst, K, Baisley, K |
LSHTM Faculty/Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology (-2023) Faculty of Epidemiology and Population Health > Dept of Medical Statistics Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
Participating Institutions | London School of Hygiene & Tropical Medicine, London, United Kingdom |
Date Deposited | 16 Jun 2021 14:25 |
Last Modified | 23 Aug 2022 14:07 |
Publisher | Africa Health Research Institute (AHRI) |
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- Data record - AHRI Data Repository (Online Data Resource)