ArticleJournal of the International AIDS Society2012
A clinician-nurse model to reduce early mortality and increase clinic retention among high-risk HIV-infected patients initiating combination antiretroviral treatment.
Article in Journal of the International AIDS Society, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Strategies for retention of heterosexual men in HIV care in sub-Saharan Africa: A systematic review.PloS one · 2021Pooled it
- Supportive interventions to improve retention on ART in people with HIV in low- and middle-income countries: A systematic review.PloS one · 2018Pooled it
- Specification of implementation interventions to address the cascade of HIV care and treatment in resource-limited settings: a systematic review.Implementation science : IS · 2017Pooled it
- Pooled it
- Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care.Tropical medicine & international health : TM & IH · 2015Pooled it
- Mother Infant Retention for Health (MIR4Health): Study Design, Adaptations, and Challenges With PMTCT Implementation Science Research.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- HIV care continuum among cisgender and transgender women sex workers in Greater Kuala Lumpur, Malaysia.AIDS care · 2023Article
- The effectiveness, feasibility and acceptability of HIV service delivery at private pharmacies in sub-Saharan Africa: a scoping review.Journal of the International AIDS Society · 2022Article
- Clinical Follow-Up in People Living with HIV During the COVID-19 Pandemic in Mexico.AIDS and behavior · 2022Article
- Leveraging the power of partnerships: spreading the vision for a population health care delivery model in western Kenya.Globalization and health · 2018Article
- Is more research always needed? Estimating optimal sample sizes for trials of retention in care interventions for HIV-positive East Africans.BMJ global health · 2017Article
- Improving antiretroviral therapy adherence in resource-limited settings at scale: a discussion of interventions and recommendations.Journal of the International AIDS Society · 2017Article
- Self-reported practices among traditional birth attendants surveyed in western Kenya: a descriptive study.BMC pregnancy and childbirth · 2016Article
- Retention and mortality outcomes from a community-supported public-private HIV treatment programme in Myanmar.Journal of the International AIDS Society · 2016Article
- Impact and Cost-Effectiveness of Hypothetical Strategies to Enhance Retention in Care within HIV Treatment Programs in East Africa.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2015Article
- Survival rate: an indicator of the management of acquired immune deficiency syndrome using Traditional Chinese Medicine.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2015Review
- Marginal and Conditional Distribution Estimation from Double-Sampled Semi-Competing Risks Data.Scandinavian journal of statistics, theory and applications · 2015Article
- Enhancing linkage and retention in HIV care: a review of interventions for highly resourced and resource-poor settings.Current HIV/AIDS reports · 2014Review
- Follow-Up Visit Patterns in an Antiretroviral Therapy (ART) programme in Zomba, Malawi.PloS one · 2014Article
- Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundIn resource-poor settings, mortality is at its highest during the first 3 months after combination antiretroviral treatment (cART) initiation. A clear predictor of mortality during this period is having a low CD4 count at the time of treatment initiation. The objective of this study was to evaluate the effect on survival and clinic retention of a nurse-based rapid assessment clinic for high-risk individuals initiating cART in a resource-constrained setting.
methodsThe USAID-AMPATH Partnership has enrolled more than 140,000 patients at 25 clinics throughout western Kenya. High Risk Express Care (HREC) provides weekly or bi-weekly rapid contacts with nurses for individuals initiating cART with CD4 counts of ≤100 cells/mm3. All HIV-infected individuals aged 14 years or older initiating cART with CD4 counts of ≤100 cells/mm3 were eligible for enrolment into HREC and for analysis. Adjusted hazard ratios (AHRs) control for potential confounding using propensity score methods.
resultsBetween March 2007 and March 2009, 4,958 patients initiated cART with CD4 counts of ≤100 cells/mm3. After adjusting for age, sex, CD4 count, use of cotrimoxazole, treatment for tuberculosis, travel time to clinic and type of clinic, individuals in HREC had reduced mortality (AHR: 0.59; 95% confidence interval: 0.45-0.77), and reduced loss to follow up (AHR: 0.62; 95% CI: 0.55-0.70) compared with individuals in routine care. Overall, patients in HREC were much more likely to be alive and in care after a median of nearly 11 months of follow up (AHR: 0.62; 95% CI: 0.57-0.67).
conclusionsFrequent monitoring by dedicated nurses in the early months of cART can significantly reduce mortality and loss to follow up among high-risk patients initiating treatment in resource-constrained settings.
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