ArticleJournal of the International AIDS Society2024
Retention on antiretroviral therapy and drivers of lost-to-follow up in the Central African Republic: a longitudinal analysis.
Article in Journal of the International AIDS Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Navigating the HIV continuum of care from treatment to retention strategies in Carnot, Central African Republic: a sequential explanatory mixed-methods study.BMJ global health · 2026Article
- Contextual Drivers of HIV Vulnerability and Retention in Care in the Central African Republic: An Ecological Analysis.AIDS and behavior · 2026Article
- Trends, magnitude and determinants of viral load suppression among HIV patients on highly active anti-retroviral therapy in Tigray region, Ethiopia: a retrospective study (2016-2024).BMC infectious diseases · 2026Article
- Retention and predictors of loss-to-follow-up among patients on antiretroviral therapy in the Test-and-Treat Era: evidence from a retrospective cohort study in Maputo, Mozambique.BMC infectious diseases · 2026Article
- A scalable ultra-long-acting tenofovir phosphonate prodrug sustains HBV suppression.Science advances · 2025Article
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22 authors.
Funding
Abstract
introductionThe retention in care of patients undergoing antiretroviral therapy (ART) is a cornerstone for preventing AIDS-associated morbidity and mortality, as well as further transmission of HIV. Adherence to ART poses particular challenges in conflict-affected settings like the Central African Republic (CAR). The study objective was to estimate the rate of lost-to-follow-up (LTFU) and determine factors associated with LTFU among patients living with HIV under ART in CAR.
methodsA retrospective cohort analysis was conducted using data from patients being managed at 42 representative ART dispensing sites (i.e. management of ≥200 patients) in the seven health regions of CAR which started ART between January 2019 to September 2021 and followed up to December 2021. The outcome of LTFU was defined as a failure of a patient to attend a scheduled ART refill appointment for at least 90 days from the last appointment. Patients were censored at the first LTFU event.
resultsA total of 6844 patients enrolled in ART care were included in the analysis, of whom 67.5% were females. The mean age (standard deviation) was 35.3 years (10.5). Forty-two per cent (n = 2874/6844) had an LTFU event during the follow-up period. However, 23.2% (n = 666/2874) returned to care after LTFU. Overall retention in antiretroviral care at 12 months was 64.2% (CI 63.0-65.5), which ranged from 76.1% in the capital to 48.2% in the inner country region. Risk factors related to LTFU were being male (adjusted hazard ratio [aHR] 1.33; CI 1.1-1.5), age < 25 (aHR 1.46; CI 1.1-1.9), living in regions outside the capital (aHR 1.83; CI 1.6-2.3) and undernutrition (aHR 1.13; CI 1.0-1.3).
conclusionsRetention to care in CAR is suboptimal, especially in the inner country. Our results underline the difficulties involved in retaining patients in ART in complex settings, the interplay between poor retention, social unrest, stigma, food insecurity and HIV epidemic control, and the need for tailored programming and interventions like differentiated treatment strategies and complementary food provision.
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