ArticleJournal of acquired immune deficiency syndromes (1999)2014
Risk factors for delayed initiation of combination antiretroviral therapy in rural north central Nigeria.
Article in Journal of acquired immune deficiency syndromes (1999), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- The HIV care cascade in sub-Saharan Africa: systematic review of published criteria and definitions.Journal of the International AIDS Society · 2021Pooled it
- Pooled it
- Time to initiation of antiretroviral therapy and its predictors among newly diagnosed HIV positive at the selected public health centers in Adama Town, Ethiopia.AIDS research and therapy · 2025Article
- Prevalence, Predictors, and Outcomes of HIV Care in HIV-Positive Clients Entering HIV Care With Advanced HIV Disease in Sub-Saharan Africa 2010-2022: Systematic Review and Meta-Analysis.Health science reports · 2024Article
- Immunodeficiency at Antiretroviral Therapy Start: Five-Year Adult Data (2012-2017) Based on Evolving National Policies in Rural Mozambique.AIDS research and human retroviruses · 2020Article
- Timing and Predictors of Initiation on Antiretroviral Therapy Among Newly-Diagnosed HIV-Infected Persons in South Africa.AIDS and behavior · 2019Article
- Diagnosis of Human Immunodeficiency Virus Infection.Clinical microbiology reviews · 2019Review
- Failure to initiate HIV treatment in patients with high CD4 counts: evidence from demographic surveillance in rural South Africa.Tropical medicine & international health : TM & IH · 2018Article
- Predictors of timely linkage-to-ART within universal test and treat in the HPTN 071 (PopART) trial in Zambia and South Africa: findings from a nested case-control study.Journal of the International AIDS Society · 2017Article
- Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa.Southern African journal of HIV medicine · 2017Article
- Risk factors for delayed antiretroviral therapy initiation among HIV-seropositive patients.PloS one · 2017Article
- Article
- Article
- Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men.International health · 2015Article
- Change of treatment guidelines and evolution of ART initiation in rural South Africa: data of a large HIV care and treatment programme.BMC infectious diseases · 2015Article
- Enrolment trends in a comprehensive HIV programme in rural north-central Nigeria: improved care indices, but declining quality of clinical data over time.Pathogens and global health · 2015Observational
- Time to initiation of antiretroviral therapy among patients who Are ART eligible in Rwanda: improvement over time.Journal of acquired immune deficiency syndromes (1999) · 2015Article
- Article
- The influence of race and comorbidity on the timely initiation of antiretroviral therapy among older persons living with HIV/AIDS.American journal of public health · 2014Article
- Correlates of suboptimal entry into early infant diagnosis in rural north central Nigeria.Journal of acquired immune deficiency syndromes (1999) · 2014Observational
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundTimely initiation of combination antiretroviral therapy (ART) in eligible HIV-infected patients is associated with substantial reduction in mortality and morbidity. Nigeria has the second largest number of persons living with HIV/AIDS in the world. We examined patient characteristics, time to ART initiation, retention, and mortality at 5 rural facilities in Kwara and Niger states of Nigeria.
methodsWe analyzed program-level cohort data for HIV-infected ART-naive clients (≥15 years) enrolled from June 2009 to February 2011. We modeled the probability of ART initiation among clients meeting national ART eligibility criteria using logistic regression with splines.
resultsWe enrolled 1948 ART-naive adults/adolescents into care, of whom, 1174 were ART eligible (62% female). Only 74% of the eligible patients (n = 869) initiated ART within 90 days after enrollment. The median CD4 count for eligible clients was 156 cells/μL (interquartile range: 81-257), with 67% in WHO stage III/IV disease. Adjusting for CD4 count, WHO stage, functional status, hemoglobin, body mass index, sex, age, education, marital status, employment, clinic of attendance, and month of enrollment, we found that immunosuppression [CD4 350 vs. 200, odds ratio (OR) = 2.10, 95% confidence interval (CI): 1.31 to 3.35], functional status [bedridden vs. working, OR = 4.17 (95% CI: 1.63 to 10.67)], clinic of attendance [Kuta Hospital vs. referent: OR = 5.70 (95% CI: 2.99 to 10.89)], and date of enrollment [December 2010 vs. June 2009: OR = 2.13 (95% CI: 1.19 to 3.81)] were associated with delayed ART initiation.
conclusionsDelayed initiation of ART was associated with higher CD4 counts, lower functional status, clinic of attendance, and later dates of enrollment among ART-eligible clients. Our findings provide targets for quality improvement efforts that may help reduce attrition and improve ART uptake in similar settings.
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