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AIDS Care
Psychological and Socio-medical Aspects of AIDS/HIV
Volume 31, 2019 - Issue 4
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Articles

Enhancing value and lowering costs of care: a qualitative exploration of a randomized linkage to care intervention in South Africa

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Pages 481-488 | Received 12 Jan 2018, Accepted 10 Jul 2018, Published online: 05 Aug 2018
 

ABSTRACT

While interventions to improve HIV linkage and retention in care exist, none have demonstrated results sufficient to reach UNAIDS 90-90-90 goals. We explored values and costs of seeking clinical care through testing three strategies to improve linkage to care: Point of care CD4 testing alone (POC-CD4), POC-CD4 combined with transportation support and combined with care facilitation. We conducted in-depth interviews with participants and transcribed audio-recordings of care facilitation sessions. Participants described values and costs enhanced or addressed by the three interventions. Psychosocial support provided through the care facilitation intervention appeared salient. Participants named other values and costs of seeking care unrelated to the intervention, such as encouragement from healthcare workers and aversion to lifelong treatment. Combined with the quantitative results of this trial, these findings may point to why the care facilitation arm was successful but not the POC-CD4 only or transportation arms. It also provides guidance for future interventions.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by United States Agency for International Development [Cooperative Agreement AID-OAAA-A-12-00028].

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