ArticlePloS one2019
Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Investigating strategies to enhance access to HIV services among children in Malawi: A multifaceted research approach, study protocol.PloS one · 2026Article
- Evaluating the effect of interactive two-way texting on 6-month antiretroviral therapy outcomes: Findings from a randomized controlled trial in Lilongwe, Malawi.PLOS global public health · 2025Article
- Clinical outcomes in the era of test and treat among children living with HIV: a retrospective before/after study in Zambia.Frontiers in pediatrics · 2025Article
- Programmatic outcomes of adolescents in differentiated service delivery models in South Africa.Southern African journal of infectious diseases · 2025Article
- Tumor-Associated Edema in Children with Kaposi Sarcoma: 14 Years' Experience at Kamuzu Central Hospital, Lilongwe, Malawi.Cancers · 2024Article
- Improving HIV testing and retention among adolescents and youths: Lessons from a quasi-experimental study of the Red-Carpet Program in Malawi.PLOS global public health · 2024Article
- Article
- Cost-effectiveness analysis of a two-way texting (2wT) intervention to improve ART retention among newly-initiated antiretroviral therapy clients in Malawi.Oxford open digital health · 2024Article
- Improving retention and HIV viral load suppression among adolescents living with HIV in TASO Soroti and TASO Mbale centers of excellence using Operation Triple Zero model: a before and after study protocol.Implementation science communications · 2023Article
- Understanding the Unique Barriers and Facilitators that Affect Men's Initiation and Retention in HIV Care: A Qualitative Study to Inform Interventions for Men Across the Treatment Cascade in Malawi.AIDS and behavior · 2023Article
- Historical visit attendance as predictor of treatment interruption in South African HIV patients: Extension of a validated machine learning model.PLOS global public health · 2023Article
- The Positive Impact of Foods Support on Loss to Follow Up Among Children and Adolescents on HIV Antiretroviral Therapy in a District Hospital in East Cameroon.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Article
- Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis.Journal of the International AIDS Society · 2022Article
- Rates and Determinants of Retention on ART Among Orphans and Vulnerable Children Living With HIV in Tanzania.Frontiers in public health · 2022Article
- Ten-year attrition and antiretroviral therapy response among HIV-positive adults: a sex-based cohort analysis from eight West African countries.Journal of the International AIDS Society · 2021Article
- Observational
- Retention in care for adolescents who were newly initiated on antiretroviral therapy in the Cape Metropole in South Africa.Southern African journal of HIV medicine · 2020Article
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Authors and funding
8 authors.
Funding
Abstract
objectivesWe examine long-term retention of adults, adolescents and children on antiretroviral therapy under different HIV treatment guidelines in Malawi.
designProspective cohort study. SETTING AND
participantsAdults and children starting ART between 2005 and 2015 in 21 health facilities in southern Malawi.
methodsWe used survival analysis to assess retention at clinic level, Cox regression to examine risk factors for loss to follow up, and competing risk analysis to assess long-term outcomes of people on antiretroviral therapy (ART).
resultsWe included 132,274 individuals in our analysis, totalling 270,256 person years of follow up (PYFU; median per patient 1.3, interquartile range (IQR) 0.26-3.1), 62% were female and the median age was 32 years. Retention on ART was lower in the first year on ART compared to subsequent years for all guideline periods and age groups. Infants (0-3 years), adolescents and young adults (15-24 years) were at highest risk of LTFU. Comparing the different calendar periods of ART initiation we found that retention improved initially, but remained stable thereafter.
conclusionEven though the number of patients and the burden on health care system increased substantially during the study period of rapid ART expansion, retention on ART improved in the early years of ART provision, but gains in retention were not maintained over 5 years on ART. Reducing high attrition in the first year of ART should remain a priority for ART programs, and so should addressing poor retention among adolescents, young adults and men.
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