ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Patient-reported Reasons for Stopping Care or Switching Clinics in Zambia: A Multisite, Regionally Representative Estimate Using a Multistage Sampling-based Approach in Zambia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06803316 (Optimizing Care Delivery to Support Reengagement in PLWH Returning to HIV Care After Treatment Lapses in Zambia), which is not on this map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
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.
Optimizing Care Delivery to Support Reengagement in PLWH Returning to HIV Care After Treatment Lapses in Zambia
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Pooled it
- Trial
- Behaviourally-Informed Two-Way Text Messaging to Improve Return to HIV Care in South Africa: Evidence from a Randomised Controlled Trial.AIDS and behavior · 2025Trial
- Effect of a multicomponent, person-centred care intervention on client experience and HIV treatment outcomes in Zambia: a stepped-wedge, cluster-randomised trial.The lancet. HIV · 2025Trial
- Trial
- Article
- Identifying care gaps along the HIV treatment failure cascade: A multistate analysis of viral load monitoring, re-suppression, and regimen switches in Zambia.PLoS medicine · 2025Article
- The need to differentiate at re-engagement: lessons from South Africa and Zimbabwe's re-engagement algorithms.Journal of the International AIDS Society · 2025Article
- Prevalence of advanced HIV disease in sub-Saharan Africa: a multi-country analysis of nationally representative household surveys.The Lancet. Global health · 2025Article
- Depression and the revolving door of HIV care: using multistate approaches to understand complex longitudinal exposure/outcome relationships among a cohort of people entering HIV care in Cameroon from 2019 to 2020.BMJ public health · 2025Article
- The heterogeneity among people re-engaging in antiretroviral therapy highlights the need for a differentiated approach: results from a cross-sectional study in Johannesburg, South Africa.Journal of the International AIDS Society · 2024Article
- Clinic transfers and engagement in HIV care during the perinatal period across a network of healthcare centers in Lilongwe, Malawi.BMC pregnancy and childbirth · 2024Article
- 'Not taking medications and taking medication, it was the same thing:' perspectives of antiretroviral therapy among people hospitalised with advanced HIV disease.BMC infectious diseases · 2024Article
- Incidence of Health Facility Switching and Associations With HIV Viral Rebound Among Persons on Antiretroviral Therapy in Uganda: A Population-based Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Patterns of person-centred communications in public HIV clinics: a latent class analysis using the Roter interaction analysis system.Journal of the International AIDS Society · 2023Article
- The importance of the "how": the case for differentiated service delivery of long-acting and extended delivery regimens for HIV prevention and treatment.Journal of the International AIDS Society · 2023Article
- Provider perspectives on patient-centredness: participatory formative research and rapid analysis methods to inform the design and implementation of a facility-based HIV care improvement intervention in Zambia.Journal of the International AIDS Society · 2023Article
- Trajectories of re-engagement: factors and mechanisms enabling patient return to HIV care in Zambia.Journal of the International AIDS Society · 2023Article
- Effect of Test and Treat on clinical outcomes in Nigeria: A national retrospective study.PloS one · 2023Article
- Availability and experiences of differentiated antiretroviral therapy delivery at HIV care facilities in rural Zimbabwe: a mixed-method study.Journal of the International AIDS Society · 2022Article
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundUnderstanding patient-reported reasons for lapses of retention in human immunodeficiency virus (HIV) treatment can drive improvements in the care cascade. A systematic assessment of outcomes among a random sample of patients lost to follow-up (LTFU) from 32 clinics in Zambia to understand the reasons for silent transfers and disengagement from care was undertaken.
methodsWe traced a simple random sample of LTFU patients (>90 days from last scheduled visit) as determined from clinic-based electronic medical records from a probability sample of facilities. Among patients found in person, we solicited reasons for either stopping or switching care and predictors for re-engagement. We coded reasons into structural, psychosocial, and clinic-based barriers.
resultsAmong 1751 LTFU patients traced and found alive, 31% of patients starting antiretroviral therapy (ART) between 1 July 2013 and 31 July 2015 silently transferred or were disengaged (40% male; median age, 35 years; median CD4 level, 239 cells/μL); median time on ART at LTFU was 480 days (interquartile range, 110-1295). Among the 544 patients not in care, median prevalences for patient-reported structural, psychosocial, and clinic-level barriers were 27.3%, 13.9%, and 13.4%, respectively, and were highly variable across facilities. Structural reasons, including, "relocated to a new place" were mostly cited among 289 patients who silently transferred (35.5%). We found that men were less likely to re-engage in care than women (odds ratio, .39; 95% confidence interval, .22-.67; P = .001).
conclusionsEfforts to improve retention of patients on ART may need to be tailored at the facility level to address patient-reported barriers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.