Data from: Linkage into care among newly diagnosed HIV-positive individuals tested through outreach and facility-based HIV testing models in Mbeya, Tanzania: a prospective mixed-method cohort study

Objective: Linkage to care is the bridge between HIV testing and HIV
treatment, care and support. In Tanzania, mobile testing aims to address
historically low testing rates. Linkage to care was reported at 14% in
2009 and 28% in 2014. The study compares linkage to care of HIV-positive
individuals tested at mobile/outreach versus public health facility-based
services within the first 6 months of HIV diagnosis. Setting: Rural
communities in four districts of Mbeya Region, Tanzania. Participants: A
total of 1012 newly diagnosed HIV-positive adults from 16 testing
facilities were enrolled into a two-armed cohort and followed for 6 months
between August 2014 and July 2015. 840 (83%) participants completed the
study. Main outcome: measures We compared the ratios and time variance in
linkage to care using the Kaplan-Meier estimator and Log rank tests. Cox
proportional hazards regression models to evaluate factors associated with
time variance in linkage. Results: At the end of 6 months, 78% of all
respondents had linked into care, with differences across testing models.
84% (CI 81% to 87%, n=512) of individuals tested at facility-based site
were linked to care compared to 69% (CI 65% to 74%, n=281) of individuals
tested at mobile/outreach. The median time to linkage was 1 day (IQR:
1–7.5) for facility-based site and 6 days (IQR: 3–11) for mobile/outreach
sites. Participants tested at facility-based site were 78% more likely to
link than those tested at mobile/outreach when other variables were
controlled (AHR=1.78; 95% CI 1.52 to 2.07). HIV status disclosure to
family/relatives was significantly associated with linkage to care
(AHR=2.64; 95% CI 2.05 to 3.39). Conclusions: Linkage to care after
testing HIV positive in rural Tanzania has increased markedly since 2014,
across testing models. Individuals tested at facility-based sites linked
in significantly higher proportion and modestly sooner than
mobile/outreach tested individuals. Mobile/outreach testing models bring
HIV testing services closer to people. Strategies to improve linkage from
mobile/outreach models are needed.