OBJECTIVE: To investigate the prevalence of social exposure to a large, government-run ART programme in rural South Africa. METHOD: Clinical data on 6681 patients were matched with demographic data on a nearly complete cohort of 102,359 people residing in the programme catchment area. We calculated the proportion of residents in the demographic surveillance area that were members of a household, or resided in a compound where someone had initiated ART or received pre-ART care. RESULTS: By January 2010, 3% of the population had initiated ART. However, 25% of the population shared household membership or resided in a compound with someone who had initiated ART; 40% shared household or living arrangements with people who had either initiated ART or were enrolled in pre-ART care. CONCLUSION: Such high rates of social exposure suggest that ART programmes in HIV endemic areas are likely to have significant population-level effects on social norms and economic welfare. These results also point to the opportunity to reach large numbers of people with health and social services through existing ART programmes.
OBJECTIVE: To investigate the prevalence of social exposure to a large, government-run ART programme in rural South Africa. METHOD: Clinical data on 6681 patients were matched with demographic data on a nearly complete cohort of 102,359 people residing in the programme catchment area. We calculated the proportion of residents in the demographic surveillance area that were members of a household, or resided in a compound where someone had initiated ART or received pre-ART care. RESULTS: By January 2010, 3% of the population had initiated ART. However, 25% of the population shared household membership or resided in a compound with someone who had initiated ART; 40% shared household or living arrangements with people who had either initiated ART or were enrolled in pre-ART care. CONCLUSION: Such high rates of social exposure suggest that ART programmes in HIV endemic areas are likely to have significant population-level effects on social norms and economic welfare. These results also point to the opportunity to reach large numbers of people with health and social services through existing ART programmes.
Authors: Harsha Thirumurthy; Markus Goldstein; Joshua Graff Zivin; James Habyarimana; Cristian Pop-Eleches Journal: Forum Health Econ Policy Date: 2012-04-19
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