What Is the Impact of Home-Based HIV Counseling and Testing on the Clinical Status of Newly Enrolled Adults in a Large HIV Care Program in Western Kenya?
Bibliographic record
Abstract
BACKGROUND: This article describes the effect point of entry into the human immunodeficiency virus (HIV) care program had on the clinical status of adults presenting for the first time to USAID-AMPATH (US Agency for International Development-Academic Model Providing Access to Healthcare) Partnership clinics for HIV care. METHODS: All patients aged ≥ 14 years enrolled between August 2008 and April 2010 were included. Points of entry to USAID-AMPATH clinics were home-based counseling and testing (HBCT), provider-initiated testing and counseling (PITC), HIV testing in the tuberculosis clinic, and voluntary counseling and testing (VCT). Tests for trend were calculated, and multivariable logistic regression was used to compare the effect of HBCT versus other points of entry on primary outcomes controlling for age and sex. RESULTS: There were 19,552 eligible individuals. Of these, 946 tested in HBCT, 10,261 in VCT, 8073 in PITC, and 272 in the tuberculosis clinic. The median (interquartile range) enrollment CD4 cell counts among those who tested HIV positive was 323 (194-491), 217 (87-404), 190 (70-371), and 136 cells/mm(3) (59-266) for HBCT, VCT, PITC, and the tuberculosis clinic, respectively (P < .001). Compared with those patients whose HIV infection was diagnosed in the tuberculosis clinic, those who tested positive in HBCT were, controlling for age and sex, less likely to have to have World Health Organization stage III or IV HIV infection at enrollment (adjusted odds ratio [AOR], 0.04; 95% confidence interval [CI], .03-.06), less likely to enroll with a CD4 cell count of <200 cells/mm(3) (AOR, 0.20; 95% CI, .14-.28), and less likely to enroll into care with a chief complaint (AOR, 0.08; 95% CI, .05-.12). CONCLUSIONS: HBCT is effective at getting HIV-infected persons enrolled in HIV care before they become ill.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".