ArticlePloS one2013
Loss to follow-up as a competing risk in an observational study of HIV-1 incidence.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- HIV incidence among women engaging in sex work in sub-Saharan Africa: a systematic review and meta-analysis.The Lancet. Global health · 2024Pooled it
- Pooled it
- Factors associated with vaccination completion and retention among HIV negative female sex workers enrolled in a simulated vaccine efficacy trial in Kampala, Uganda.BMC infectious diseases · 2019Trial
- Decline in HIV prevalence among female sex workers in Zimbabwe between 2013 and 2023.Nature communications · 2025Article
- Evaluating tuberculosis treatment outcomes in Haiti from 2018 to 2019: A competing risk analysis.IJID regions · 2024Article
- Estimating the mortality risk correcting for high loss to follow-up among female sex workers with HIV in Durban, South Africa, 2018-2021.Annals of epidemiology · 2024Article
- The epidemiology of HIV infection among female sex workers in Nairobi, Kenya: A structural determinants and life-course perspective.PLOS global public health · 2024Article
- HIV incidence among women engaging in sex work in sub-Saharan Africa: a systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2023Article
- Loss to follow-up among female sex workers in Zambia: findings from a five-year HIV-incidence cohort.African journal of AIDS research : AJAR · 2020Article
- A semiparametric method for the analysis of outcomes during a gap in HIV care under incomplete outcome ascertainment.Statistical communications in infectious diseases · 2020Article
- Comparison of retention in observational cohorts and nested simulated HIV vaccine efficacy trials in the key populations in Uganda.BMC medical research methodology · 2020Observational
- Barriers to Condom Use Among Female Sex Workers in Tehran, Iran: A Qualitative Study.International journal of women's health · 2020Article
- Using Composite Scores to Summarize Adolescent Sexual Risk Behavior: Current State of the Science and Recommendations.Archives of sexual behavior · 2019Article
- Female sex workers in Kigali, Rwanda: a key population at risk of HIV, sexually transmitted infections, and unplanned pregnancy.International journal of STD & AIDS · 2019Article
- Article
- Proportion and predictors of loss to follow-up in a longitudinal cohort study of female entertainment and sex workers in Cambodia.International journal of STD & AIDS · 2018Article
- Patterns of Gender-Based Violence and Associations with Mental Health and HIV Risk Behavior Among Female Sex Workers in Mombasa, Kenya: A Latent Class Analysis.AIDS and behavior · 2018Article
- Recruitment of Female Sex Workers in HIV Prevention Trials: Can Efficacy Endpoints Be Reached More Efficiently?Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Prediction of the 20-year incidence of diabetes in older Chinese: Application of the competing risk method in a longitudinal study.Medicine · 2016Observational
- Loss to follow-up and HIV incidence in female sex workers in Kaiyuan, Yunnan Province China: a nine year longitudinal study.BMC infectious diseases · 2016Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
Abstract
objectiveConventional survival estimates may be biased if loss to follow-up (LTF) is associated with the outcome of interest. Our goal was to assess whether the association between sexual risk behavior and HIV-1 acquisition changed after accounting for LTF with competing risks regression.
methodsHIV-1-seronegative women who enrolled in a Kenyan sex worker cohort from 1993-2007 were followed prospectively and tested for HIV at monthly clinic visits. Our primary predictor was self-reported sexual risk behavior in the past week, analyzed as a time-dependent covariate. Outcomes included HIV-1 acquisition and LTF. We analyzed the data using Cox proportional hazards regression and competing risks regression, in which LTF was treated as a competing event.
resultsA total of 1,513 women contributed 4,150 person-years (py), during which 198 (13.1%) acquired HIV-1 infection (incidence, 4.5 per 100 py) and 969 (64.0%) were LTF (incidence, 23.4 per 100 py). After adjusting for potential confounders, women reporting unprotected sex with multiple partners were less likely to be lost to follow-up (adjusted sub-hazard ratio (aSHR) 0.50, 95% confidence interval (CI) 0.32-0.76, relative to no sexual activity). The risk of HIV-1 acquisition after reporting unprotected sex with multiple partners was similar with Cox regression (adjusted hazard ratio (aHR) 2.41, 95% CI 1.36-4.27) and competing risks regression (aSHR 2.47, 95% CI 1.33-4.58).
conclusionsUnprotected sex with multiple partners was associated with higher HIV-1 acquisition risk, but lower attrition. This differential attrition did not substantially bias Cox regression estimates when compared to competing risks regression results.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.