Multi-level determinants of Late ART Initiation in Sub-Saharan Africa (LSTART)

The LSTART Study examines the multi-level factors associated with late antiretroviral therapy (ART) initiation in Kenya, Mozambique, Rwanda, Ethiopia and Tanzania. The study covers multiple areas including, 1) multi-level factors (contextual, clinic, and individual) associated with late ART initiation; 2) clinic-level barriers and enablers to timely enrollment, identified through observation of provider-patient interactions and provider in-depth interviews at four clinics in Ethiopia and 3) identification of individual risk factors for late ART initiation through quantitative surveys from 6 clinics in Ethiopia that combine cross-sectional survey data with longitudinal service delivery/clinic data and include information on HIV testing and care history, HIV beliefs, stigma, disclosure, quality of life and sexual behavior.  The study is a collaboration between the CUNY ISPH, Columbia University-ICAP, the HIV Center for Clinical and Behavioral Studies at Columbia University, and the Oromia Regional Bureau of Health.

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