ArticlePloS one2017
Facilitators and barriers for retention in HIV care between testing and treatment in Asia-A study in Bangladesh, Indonesia, Lao, Nepal, Pakistan, Philippines and Vietnam.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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30 citing papers in PubMed.
- Barriers to Antiretroviral Therapy Adherence in Rural and Urban Areas in Indonesia: Perspectives of People Living with HIV and Healthcare Professionals.Tropical medicine and infectious disease · 2026Article
- Determinants of return to HIV treatment after interruption on ART among HIV positive clients in Katakwi District, Uganda.PloS one · 2026Article
- Determinants of loss to follow-up among people living with HIV receiving antiretroviral therapy in a universal test and treat setting: A retrospective cohort study in Nepal.Public health in practice (Oxford, England) · 2025Article
- Effects of Alcohol Use on Patient Retention in HIV Care in East Africa.AIDS and behavior · 2024Article
- Multilevel determinants of antiretroviral therapy initiation and retention in the test-and-treat era of Nepal: a qualitative study.BMC health services research · 2024Article
- The State of the HIV Epidemic in the Philippines: Progress and Challenges in 2023.Tropical medicine and infectious disease · 2023Review
- Place of death and associated factors among reviewed maternal deaths in Ethiopia: a generalised structural equation modelling.BMJ open · 2023Review
- The Correlates of Health Facility-related Stigma and Health-seeking Behaviors of People Living with HIV.Acta medica Philippina · 2023Article
- A descriptive retrospective study on HIV care cascade in a tertiary hospital in the Philippines.PloS one · 2023Article
- Rising HIV cases in Pakistan: Start of a pandemic?Annals of medicine and surgery (2012) · 2022Article
- Association Between Maternal HIV Stigma Among South Indian Mothers Living with HIV and the CD4 Count of Children Living with HIV.AIDS and behavior · 2022Article
- Determinants of Late HIV Presentation at Ndlavela Health Center in Mozambique.International journal of environmental research and public health · 2022Article
- The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey.Healthcare (Basel, Switzerland) · 2022Article
- ART uptake and adherence among female sex workers (FSW) globally: A scoping review.Global public health · 2022Article
- Measuring the uptake of continuous care among people living with HIV receiving antiretroviral therapy and social determinants of the uptake of continuous care in the southwest of China: a cross-sectional study.BMC infectious diseases · 2021Article
- Determinants of the quality of life amongst HIV clinic attendees in Malang, Indonesia.BMC public health · 2021Article
- Health literacy of people living with HIV in a rural area in Indonesia: A cross-sectional study.Health & social care in the community · 2021Article
- Intersecting Stigmas among HIV-Positive People Who Inject Drugs in Vietnam.Health services insights · 2021Article
- Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.PloS one · 2021Article
- Examining engagement in care of women living with HIV in South India.Health care for women international · 2020Article
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6 authors.
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Abstract
introductionThe need for efficient retention in HIV care is more evident than ever because of the expansion of earlier ART initiation and the shift towards 'Test and Treat'. This study assesses factors affecting participation in the HIV care cascade among people living with HIV (PLHIV) in the Asia-Pacific Region.
methodsA total of 7843 PLHIV aged 18-50 years were recruited using targeted and venue-based sampling between October 1, 2012, and May 31, 2013, across 59 sites in 7 countries (Bangladesh, Indonesia, Lao People's Democratic Republic (Lao PDR), Nepal, Pakistan, Philippines and Vietnam). Statistically significant associations between demographic and health system determinants, and various steps in the HIV care cascade were computed using a generalized structural equation model.
resultsA high proportion of PLHIV (40-51%) presented late for HIV care and delayed linkage to care in all seven countries. However, once PLHIV enrolled in care, retention in the various steps of the care cascade including adherence to antiretroviral treatment (ART) was satisfactory. The proportion still engaged in HIV care at 36 months post HIV diagnosis, varied from 78% in Nepal to >90% in Lao PDR. Similarly, the proportion of ART initiation who also were adherent to ART ranged from 91% in Bangladesh to >95% in Philippines/ Vietnam and from 70% in Lao PDR to 89% in the Philippines respectively. The following factors enhanced the likelihood of ART initiation and high adherence to HIV care and ART: good client-provider communication, high HIV treatment literacy, a referral from a health worker and TB/HIV co-infection. The following barriers were identified: young age, sex work, imprisonment, transgender identity, illiteracy, rural residence, alcohol/ injecting drug use, perceived poor health status, lack of health insurance, fear of confidentiality breach, self-referral for HIV testing, and public hospital as the place of HIV diagnosis.
conclusionsHIV programme planners should ensure easy access to HIV testing and earlier linkage to HIV care among PLHIV. In addition, multiple socio-economic and health systems barriers need to be addressed along the HIV care cascade to reach the UNAIDS 90-90-90 target in the Asia-Pacific region.
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