ArticlePloS one2020
Understanding patient transfers across multiple clinics in Zambia among HIV infected adults.
Article in PloS one, 2020. 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 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
14 citing papers in PubMed.
- Trial
- PrEParing for Long-acting Technologies: A Multistate Analysis of PrEP Persistence and HIV and STI Lab Coverage Among Oral PrEP Initiators in St. Louis, Missouri (2014-2021).Open forum infectious diseases · 2026Article
- 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
- Patterns of engagement in care during clients' first 12 months after HIV treatment initiation in Zambia: a retrospective cohort analysis using routinely collected data.BMJ global health · 2025Article
- 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
- Identifying longitudinal patterns of HIV treatment (dis)engagement and re-engagement from oral histories of virologically unsuppressed persons in Uganda: A thematic trajectory analysis.Social science & medicine (1982) · 2023Article
- Article
- Cross-sectional study to assess depression among healthcare workers in Lusaka, Zambia during the COVID-19 pandemic.BMJ open · 2023Article
- Nothing about us without us: Community-based participatory research to improve HIV care for mobile patients in Kenya and Uganda.Social science & medicine (1982) · 2023Article
- Quantifying clinic transfers among people living with HIV in the Western Cape, South Africa: a retrospective spatial analysis.BMJ open · 2021Article
- Effects of implementing universal and rapid HIV treatment on initiation of antiretroviral therapy and retention in care in Zambia: a natural experiment using regression discontinuity.The lancet. HIV · 2021Article
- Novel Longitudinal Methods for Assessing Retention in Care: a Synthetic Review.Current HIV/AIDS reports · 2021Review
- The revolving door of HIV care: Revising the service delivery cascade to achieve the UNAIDS 95-95-95 goals.PLoS medicine · 2021Article
- Monitoring Patient Adherence and Follow-up in Option B+ Program: Understanding Healthcare Workers' Practices, Challenges, and Facilitators in Lilongwe, Malawi.Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
Many patients in HIV care in Africa considered lost to follow up (LTFU) at one facility are reportedly accessing care in another. The success of these unofficial transfers as measured by time to re-entry at the new-facility, prevalence of treatment interruptions, speed of ART-initiation, and overall continuity of care is not well characterized but may reveal opportunities for improvement. We traced a random sample of LTFU HIV-infected patients in Zambia. Among those found alive and reported in care at a new-facility, we reviewed records at the receiving facility to verify transfer; and when verified, documented the transfer experience. We used Kaplan-Meier methods to examine incidence of ART-initiation after transfer to new clinic. We assessed demographic and clinical characteristics, official and cross-provincial transfer for associations with HIV treatment re-engagement using Poisson regression models and associations between official-transfer and same-day ART initiation at the new-facility. Among 350 LTFU-patients, 178 (51%) were successfully verified through chart review at the new-facility. 132 (74.2%) were female, 72 (40.4%) aged 25-35, and 51% were ever recorded as previously being on ART. 110 patients (61.8%) were registered under new ART-IDs and 97 (54.5%) received a new HIV test. 54% of those previously on ART-initiated on the same-day. Using the same ART-ID was associated with same-day initiation compared to those receiving a new ART-ID (p = 0.07). 80% (n = 91) of those ever on ART had evidence of medication initiation at new clinic. Among these, initiation reached 66% (95% CI: 56-75) by 30 days, 77.5% (95% CI: 68-86) by 90 days after new-facility presentation. Many patients use new identifiers at new facilities, indicative of inefficiencies. Re-entry into new facilities among the unofficial-transfer population is often delayed and timely treatment initiation is inconsistent, suggesting interruptions in treatment. Health systems innovations to ensure smooth and safe transfers are needed to maintain quality HIV care.
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