ArticleJournal of the International AIDS Society2018
Retention in clinic versus retention in care during the first year of HIV care in Nairobi, Kenya: a prospective cohort study.
Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Systematic review and meta-analysis of retention and disengagement after initiation on antiretroviral therapy in low- and middle-income countries after the introduction of Universal Test and Treat policies.Journal of the International AIDS Society · 2025Pooled it
- Strategies for retention of heterosexual men in HIV care in sub-Saharan Africa: A systematic review.PloS one · 2021Pooled it
- Loss to Follow-Up and Visit Nonadherence in an HIV Incidence Cohort in Kisumu, Kenya.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Predictors of retention in the prospective HIV prevention OKAPI cohort in Kinshasa.Scientific reports · 2021Observational
- Gone But Not Lost: Implications for Estimating HIV Care Outcomes When Loss to Clinic Is Not Loss to Care.Epidemiology (Cambridge, Mass.) · 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
- HIV Care Cascade among Prisoners of the Mandalay Central Prison in Myanmar: 2011-2018.Tropical medicine and infectious disease · 2020Article
- The impact of PEPFAR transition on HIV service delivery at health facilities in Uganda.PloS one · 2019Article
- Retention in clinic versus retention in care during the first year of HIV care in Nairobi, Kenya: a prospective cohort study.Journal of the International AIDS Society · 2018Article
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Authors and funding
8 authors at 6 institutions in 4 countries.
Funding
Abstract
introductionWhen measuring the success of HIV programmes to retain patients in care, few studies distinguish between retention in clinic (individual returns to the same clinic) and retention in care (individual is active in care at initial site or elsewhere). The objectives of this study were to quantify retention in clinic versus retention in care and determine risk factors associated with attrition from care in low-income settings in Nairobi, Kenya.
methodsBetween April 2013 and June 2015, adults testing positive for HIV were recruited at two comprehensive care clinics in informal urban settlements. Participants were followed from the time of a positive HIV test for up to 14 months. Participants who did not return to the clinic for their 12-month appointment between 10 and 14 months after their baseline visit were traced by telephone or community outreach to determine whether they were still receiving HIV care. We used generalized linear regression to determine the association between clinical and socio-demographic factors and attrition from care at 12 months.
resultsOf the 1068 individuals screened for study participation, 775 individuals newly presenting to HIV care were included in this study. Between 10 and 14 months, 486 participants (62.7%, 95% confidence intervals [CI], 59.2% to 66.1%) returned to the clinic for their 12-month appointment (retained in clinic). After telephone tracing and community outreach, an additional 123 of 289 participants were found to be active in care at other HIV clinics (42.6%, 95% CI, 36.8% to 48.5%). Overall, 609 (78.6%, 95% CI, 75.7% to 81.5%) participants were retained in care at any HIV clinic at 12 months. Participants in higher baseline CD4 count categories were more likely to be retained than those whose baseline CD4 count was <200 cells/mm
conclusionsRetention in clinic substantially underestimated retention in care 12 months after presenting to care in this high-prevalence and low-income urban setting. Improved systems to track patients between clinics are required to accurately estimate retention in care in resource-limited settings. Although the proportion of patients retained in care was greater than expected, interventions to improve retention in care are needed to meet global targets to end the AIDS epidemic.
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