ArticleGlobal health action2017
Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti.
Article in Global health action, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Six-Months Retention on Treatment and Attrition Risk Factors among People Living with HIV in Kibera Informal Settlement, Nairobi, Kenya.International journal of environmental research and public health · 2022Trial
- Effect of Enhanced Adherence Package on Early ART Uptake Among HIV-Positive Pregnant Women in Zambia: An Individual Randomized Controlled Trial.AIDS and behavior · 2021Trial
- Effectiveness of a Lay Counselor-Led Combination Intervention for Retention of Mothers and Infants in HIV Care: A Randomized Trial in Kenya.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Long-term retention on antiretroviral treatment after enrolment in prevention of vertical HIV transmission services: a prospective cohort study in Dar es Salaam, Tanzania.Journal of the International AIDS Society · 2024Article
- Liberia adherence and loss-to-follow-up in HIV and AIDS care and treatment: A retrospective cohort of adolescents and adults from 2016-2019.PLOS global public health · 2022Article
- The Impact of Same-Day Antiretroviral Therapy Initiation Under the World Health Organization Treat-All Policy.American journal of epidemiology · 2021Article
- Estimating the effect of increasing dispensing intervals on retention in care for people with HIV in Haiti.EClinicalMedicine · 2021Article
- Short-Term Effects of the COVID-19 Pandemic on HIV Care Utilization, Service Delivery, and Continuity of HIV Antiretroviral Treatment (ART) in Haiti.AIDS and behavior · 2021Article
- Timely initiation of HIV antiretroviral therapy in Haiti 2004-2018: a retrospective cohort study.Revista panamericana de salud publica = Pan American journal of public health · 2021Article
- An EMR-Based Alert with Brief Provider-Led ART Adherence Counseling: Promising Results of the InfoPlus Adherence Pilot Study Among Haitian Adults with HIV Initiating ART.AIDS and behavior · 2020Article
- Toward Universal HIV Treatment in Haiti: Time Trends in ART Retention After Expanded ART Eligibility in a National Cohort From 2011 to 2017.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Expanded access to viral load testing and use of second line regimens in Haiti: time trends from 2010-2017.BMC infectious diseases · 2020Article
- HIV programmatic outcomes following implementation of the 'Treat-All' policy in a public sector setting in Eswatini: a prospective cohort study.Journal of the International AIDS Society · 2020Article
- Article
- Adolescent pregnancy at antiretroviral therapy (ART) initiation: a critical barrier to retention on ART.Journal of the International AIDS Society · 2018Article
- The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.International health · 2018Article
- Moving toward test and start: learning from the experience of universal antiretroviral therapy programs for HIV-infected pregnant/ breastfeeding women.AIDS (London, England) · 2017Article
- A Proposed Framework for the Implementation of Early Infant Diagnosis Point-of-Care.AIDS research and human retroviruses · 2017Article
- ART attrition and risk factors among Option B+ patients in Haiti: A retrospective cohort study.PloS one · 2017Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundAccess to antiretroviral therapy (ART) has expanded in Haiti because of the adoption of Option B+ and the revision of treatment guidelines. Retention in care and treatment varies greatly and few studies have examined retention rates, particularly among women enrolled in Option B+.
objectiveTo assess attrition among pregnant and non-pregnant patients initiating ART following adoption of Option B+ in Haiti.
methodsLongitudinal data of adult patients initiated on ART from October 2012 through August 2014 at 73 health facilities across Haiti were analyzed using a survival analysis framework to determine levels of attrition. The Kaplan-Meier method and Cox proportional hazards regression were used to examine risk factors associated with attrition.
resultsAmong 17,059 patients who initiated ART, 7627 (44.7%) were non-pregnant women, 5899 (34.6%) were men, and 3533 (20.7%) were Option B+ clients. Attrition from the ART program was 36.7% at 12 months (95% CI: 35.9-37.5%). Option B+ patients had the highest level of attrition at 50.4% at 12 months (95% CI: 48.6-52.3%). While early HIV disease stage at ART initiation was protective among non-pregnant women and men, it was a strong risk factor among Option B+ clients. In adjusted analyses, key protective factors were older age (p < 0.0001), living near the health facility (p = 0.04), having another known HIV-positive household member (p < 0.0001), having greater body mass index (BMI) (p < 0.0001), pre-ART counseling (p < 0.0001), and Cotrimoxazole prophylaxis during baseline (p < 0.01). Higher attrition was associated with rapidly starting ART after enrollment (p < 0.0001), anemia (p < 0.0001), and regimen tenofovir+lamivudine+nevirapine (TDF+3TC+NVP) (p < 0.001).
conclusionsART attrition in Haiti is high among adults, especially among Option B+ patients. Identifying newly initiated patients most at risk for attrition and providing appropriate interventions could help reduce ART attrition.
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