ArticlePloS one2014
Retention and risk factors for attrition in a large public health ART program in Myanmar: a retrospective cohort analysis.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictors of Adult Retention in HIV Care: A Systematic Review.AIDS and behavior · 2018Pooled it
- Retention and predictors of loss-to-follow-up among patients on antiretroviral therapy in the Test-and-Treat Era: evidence from a retrospective cohort study in Maputo, Mozambique.BMC infectious diseases · 2026Article
- Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis.Belitung nursing journal · 2025Review
- Antiretroviral therapy (ART) coverage at public and private ART facilities in Myanmar.AIDS care · 2021Article
- HIV screening and retention in care in people who use drugs in Madrid, Spain: a prospective study.Infectious diseases of poverty · 2021Article
- Attrition and Its Predictors Among Adults Receiving First-Line Antiretroviral Therapy in Woldia Town Public Health Facilities, Northeast Ethiopia: A Retrospective Cohort Study.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Assessing depressive symptoms among people living with HIV in Yangon city, Myanmar: Does being a member of self-help group matter?PloS one · 2021Article
- Lessons for test and treat in an antiretroviral programme after decentralisation in Uganda: a retrospective analysis of outcomes in public healthcare facilities within the Lablite project.International health · 2020Article
- Performance and Outcomes of Routine Viral Load Testing in People Living with HIV Newly Initiating ART in the Integrated HIV Care Program in Myanmar between January 2016 and December 2017.Tropical medicine and infectious disease · 2020Article
- Lost to follow up rate in the first year of ART in adults initiated in a universal test and treat programme: a retrospective cohort study in Ekurhuleni District, South Africa.The Pan African medical journal · 2020Article
- Incidence and predictors of LTFU among adults with TB/HIV co-infection in two governmental hospitals, Mekelle, Ethiopia, 2009-2016: survival model approach.BMC infectious diseases · 2019Article
- Early Success With Retention in Care Among People Living With HIV at Decentralized ART Satellite Sites in Yangon, Myanmar, 2015-2016.Frontiers in public health · 2019Article
- Attrition during pre-ART and ART time periods among adolescents enrolled in Integrated HIV Care Programme in Myanmar, 2005-2017.Epidemiology and infection · 2019Article
- 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
- Long-term clinical, immunological and virological outcomes of patients on antiretroviral therapy in southern Myanmar.PloS one · 2018Article
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- Time to anti-retroviral therapy among people living with HIV enrolled into care in Myanmar: how prepared are we for 'test and treat'?Global health action · 2018Article
- The clinical utility of the urine-based lateral flow lipoarabinomannan assay in HIV-infected adults in Myanmar: an observational study.BMC medicine · 2017Observational
- Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar.BMC public health · 2017Article
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Authors and funding
14 authors.
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Abstract
backgroundThe outcomes from an antiretroviral treatment (ART) program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar.
methodsA retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC) Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up); a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models.
resultThe mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84%) patients were retained in ART program: 750 (7%) were lost to follow-up and 909 (9%) died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB) treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program.
conclusionHigh retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings.
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