ArticleJournal of the International AIDS Society2013
Factors associated with loss to clinic among HIV patients not yet known to be eligible for antiretroviral therapy (ART) in Mozambique.
Article in Journal of the International AIDS Society, 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.
- Retention in care prior to antiretroviral treatment eligibility in sub-Saharan Africa: a systematic review of the literature.BMJ open · 2015Pooled it
- Guideline
- Barriers and facilitators to the uptake of Test and Treat in Mozambique: A qualitative study on patient and provider perceptions.PloS one · 2018Trial
- SMSaúde: Evaluating Mobile Phone Text Reminders to Improve Retention in HIV Care for Patients on Antiretroviral Therapy in Mozambique.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- A combination strategy for enhancing linkage to and retention in HIV care among adults newly diagnosed with HIV in Mozambique: study protocol for a site-randomized implementation science study.BMC infectious diseases · 2014Trial
- Timing of HIV diagnosis relative to pregnancy and postpartum HIV care continuum outcomes among Latin American women, 2000 to 2017.Journal of the International AIDS Society · 2021Article
- Quantifying the gender gap in the HIV care cascade in southern Mozambique: We are missing the men.PloS one · 2021Article
- Article
- Continuum of HIV Care in Rural Mozambique: The Implications of HIV Testing Modality on Linkage and Retention.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Association between pregnancy at enrollment into HIV care and loss to care among women in the Democratic Republic of Congo, 2006-2013.PloS one · 2018Article
- Trends, treatment outcomes, and determinants for attrition among adult patients in care at a large tertiary HIV clinic in Nairobi, Kenya: a 2004-2015 retrospective cohort study.HIV/AIDS (Auckland, N.Z.) · 2018Article
- Article
- Observational Study of the Effect of Patient Outreach on Return to Care: The Earlier the Better.Journal of acquired immune deficiency syndromes (1999) · 2017Observational
- A Decade of Antiretroviral Therapy Scale-up in Mozambique: Evaluation of Outcome Trends and New Models of Service Delivery Among More Than 300,000 Patients Enrolled During 2004-2013.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- HIV Care and Treatment Beliefs among Patients Initiating Antiretroviral Treatment (ART) in Oromia, Ethiopia.AIDS and behavior · 2016Article
- Retention of mothers and infants in the prevention of mother-to-child transmission of HIV programme is associated with individual and facility-level factors in Rwanda.Journal of the International AIDS Society · 2016Article
- Risk factors for loss to follow-up prior to ART initiation among patients enrolling in HIV care with CD4+ cell count ≥200 cells/μL in the multi-country MTCT-Plus Initiative.BMC health services research · 2015Article
- When are patients lost to follow-up in pre-antiretroviral therapy care? a retrospective assessment of patients in an Ethiopian rural hospital.Infectious diseases of poverty · 2015Article
- Retention in pre-antiretroviral treatment care in a district of Karnataka, India: how well are we doing?Public health action · 2014Article
- Article
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12 authors.
Funding
Abstract
introductionRetention in HIV care prior to ART initiation is generally felt to be suboptimal, but has not been well-characterized.
methodsWe examined data on 37,352 adult pre-ART patients (ART ineligible or unknown eligibility) who enrolled in care during 2005-2008 with >1 clinical visit at 23 clinics in Mozambique. We defined loss to clinic (LTC) as >12 months since the last visit among those not known to have died/transferred. Cox proportional-hazards models were used to examine factors associated with LTC, accounting for clustering within sites.
resultsOf 37,352 pre-ART patients, 61% had a CD4 count within three months of enrolment (median CD4: 452, IQR: 345-611). 17,598 (47.1%) were ART ineligible and 19,754 (52.9%) were of unknown eligibility status at enrolment because of missing information on CD4 count and/or WHO stage. Kaplan-Meier estimates for LTC at 12 months were 41% (95% CI: 40.2-41.8) and 48% (95% CI: 47.2-48.8), respectively. Factors associated with LTC among ART ineligible patients included male sex (AHR(men_vs_non-pregnant women): 1.5; 95% CI: 1.4-1.6) and being pregnant at enrolment (AHR(pregnant_vs_non-pregnant women): 1.3; 95% CI: 1.1-1.5). Older age, more education, higher weight and more advanced WHO stage at enrolment were independently associated with lower risks of LTC. Similar findings were observed among patients whose ART eligibility status was unknown at enrolment.
conclusionsSubstantial LTC occurred prior to ART initiation among patients not yet known to be eligible for ART, including nearly half of patients without documented ART eligibility assessment. Interventions are needed to target pre-ART patients who may be at higher risk for LTC, including pregnant women and patients with less advanced HIV disease.
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