ArticleLancet regional health. Americas2024
Continuity of care during severe civil unrest with a model of community-based HIV care: a retrospective cohort study from Haiti.
Article in Lancet regional health. Americas, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Article
- Blood Pressure Trajectories Among Adults Living in Extreme Poverty: A Population-Based Cohort in Port-au-Prince, Haiti.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Trends and Disruptions in Antiretroviral Treatment Enrollment in Haiti, 2018-2024.The American journal of tropical medicine and hygiene · 2026Article
- High Burden of Cardiovascular Disease and Mental Health Illness Comorbidity in Urban Haiti.Journal of the American Heart Association · 2026Observational
- The Effect of Conflict on Medical Services for People Living With Advanced HIV Disease and Cryptococcal Meningitis in Ethiopia's Tigray Region: A Qualitative Study of Healthcare Providers.Open forum infectious diseases · 2026Article
- Applying Machine Learning to Predict Loss to Follow-Up Among People Living With HIV in Haiti Using a National Electronic Medical Record Cohort.International journal of public health · 2026Article
- Improvements in Blood Pressure Control and the Hypertension Care Continuum Over 2 Years in Urban Haiti Amidst Civil Unrest.Journal of clinical hypertension (Greenwich, Conn.) · 2025Observational
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Authors and funding
20 authors.
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Abstract
Background: There are limited data on the effectiveness of differentiated service delivery (DSD) for HIV care during sociopolitical turmoil. We assessed outcomes with a DSD model of care that includes patient choice between community-based antiretroviral therapy (ART) centres, home-based ART dispensing, or facility-based care at GHESKIO clinic during a period of severe civil unrest in Port-au-Prince, Haiti. Methods: This retrospective analysis included data on patients with at least one HIV visit at GHESKIO between May 1, 2019, and December 31, 2021. Multivariable logistic regression models were used to assess predictors of attending ≥1 community visit during the study period, and failure to attend timely visits. HIV-1 RNA test results were reported among patients who had been ART for ≥3 months at last visit. Findings: Of the 18,625 patients included in the analysis, 9659 (51.9%) attended at least one community visit. The proportion of community visits ranged from 0.3% (2019) to 44.1% (2021). Predictors of ≥1 community visit included male sex (aOR: 1.13; 95% CI: 1.06, 1.20), secondary education (aOR: 1.07; 95% CI: 1.01, 1.14), income > $USD 1.00/day (aOR: 1.24; 95% CI: 1.14, 1.35), longer duration on ART (aOR: 1.08 per additional year; 95% CI: 1.07, 1.09), and residence in Carrefour/Gressier (p < 0.0001 in comparisons with all other zones). Younger age and shorter time on ART were associated with late visits and loss to follow-up. Among 12,586 patients with an on-time final visit who had been on ART for ≥3 months, 11,131 (88.4%) received a viral load test and 9639 (86.6%) had HIV-1 RNA < 1000 copies/mL. Interpretation: The socio-political situation in Haiti has presented extraordinary challenges to the health care system, but retention and viral suppression rates remain high with a model of community-based HIV care. Additional interventions are needed to improve outcomes for younger patients, and those with shorter time on ART. Funding: No funding.
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