{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:31:19Z","timestamp":1763389879831,"version":"3.37.3"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health (NIH) administrative supplement to Existing NIH Grants and Cooperative Agreements","award":["U01AI069924 - 09"],"award-info":[{"award-number":["U01AI069924 - 09"]}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["The SAM, 320030_169967"],"award-info":[{"award-number":["The SAM, 320030_169967"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010686","name":"H2020 European Institute of Innovation and Technology","doi-asserted-by":"publisher","award":["801076"],"award-info":[{"award-number":["801076"]}],"id":[{"id":"10.13039\/100010686","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The objective of this study was to map place of cancer diagnosis in relation to Human Immunodeficiency Virus (HIV) care centre among people living with HIV (PLHIV) within South Africa (SA) using national laboratory database.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>We linked HIV and cancer laboratory data from 2004\u20132014 using supervised machine-learning algorithms. We performed a cross-sectional analysis comparing province where individuals accessed their HIV care versus where they had their cancer diagnosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Setting<\/jats:title>\n<jats:p>We used laboratory test records related to HIV diagnostics and care, such as CD4 cell counts and percentages, rapid tests, qualitative Polymerase Chain Reaction (PCR), antibody and antigen tests for HIV data that was documented as HIV positive and laboratory diagnosed cancer records from SA.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Study population<\/jats:title>\n<jats:p>Our study population consisted of HIV records from the National Health Laboratory Service (NHLS) that linked to cancer record at the National Cancer Registry (NCR) between 2004\u20132014.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Primary and secondary outcomes<\/jats:title>\n<jats:p>We linked HIV records from NHLS to cancer records at NCR in order to study the inherent characteristics of the population with both HIV and cancer.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Results<\/jats:title>\n<jats:p>The study population was 68,284 individuals with cancer and documented HIV related laboratory test. The median age at cancer diagnosis was 40 [IQR, 33\u201348] years for the study population with most cancers in PLHIV diagnosed in females 70.9% [n = 46,313]. Of all the PLHIV and cancer, 25% (n = 16,364 p &lt; 0.001) sought treatment outside their province of residence with 60.7% (n = 10,235) travelling to Gauteng. KZN had 46.6% (n = 4,107) of its PLHIV getting cancer diagnosis in Gauteng. Western Cape had 95% (n = 6,200) of PLHIV getting cancer diagnosis within the province.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec007\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our results showed health systems inequalities across provinces in SA with respect to cancer diagnosis. KZN for example had nearly half of the PLHIV getting cancer diagnosis outside the province while Western Cape is able to offer cancer diagnostic services to most of the PLHIV in the province. Gauteng is getting over burdened with referral for cancer diagnosis from other provinces. More effort is required to ensure equitable access to cancer diagnostic services within the country.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0291897","type":"journal-article","created":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T17:42:20Z","timestamp":1718300540000},"page":"e0291897","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cancer diagnostic service use in people living with HIV in South Africa: A cross-sectional study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0154-0688","authenticated-orcid":true,"given":"Victor","family":"Olago","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon","family":"Nimako","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Bartels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Bohlius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tafadzwa","family":"Dhokotera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7462-5132","authenticated-orcid":true,"given":"Matthias","family":"Egger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1955-923X","authenticated-orcid":true,"given":"Mazvita","family":"Sengayi-Muchengeti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,6,13]]},"reference":[{"key":"pone.0291897.ref001","first-page":"328","article-title":"Early Cancer Diagnosis Saves Lives, Cuts Treatment Costs.","author":"World Health Organization","year":"2017","journal-title":"Saudi Medical Journal"},{"key":"pone.0291897.ref002","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/S0140-6736(16)31798-6","article-title":"Women\u2019s cancers: shining a light on a neglected health inequity","volume":"389","author":"U Samarasekera","year":"2017","journal-title":"The Lancet"},{"key":"pone.0291897.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/esmoopen-2017-000285","article-title":"Global cancer control: Responding to the growing burden, rising costs and inequalities in access.","volume":"3","author":"GW Prager","year":"2018","journal-title":"ESMO Open."},{"key":"pone.0291897.ref004","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(15)00755-2","article-title":"Costs, affordability, and feasibility of an essential package of cancer control interventions in low-income and middle-income countries: key messages from Disease Control Priorities, 3rd edition","volume":"387","author":"H Gelband","year":"2016","journal-title":"Lancet"},{"volume-title":"GUIDE TO CANCER\u2014Guide to cancer early diagnosis.","year":"2017","author":"WHO","key":"pone.0291897.ref005"},{"key":"pone.0291897.ref006","unstructured":"iol.co.za. 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