scholarly journals 1319. Events of Disengagement from HIV care and Subsequent Reengagement in a Kenyan Pastoralist Community: Frequency, Determinants, and Patient Views

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S476-S477
Author(s):  
Paul Otieno Yonga ◽  
Stephen Kiplimo Kalya ◽  
Lutgarde Lynen ◽  
Tom Decroo
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Hospital Admissions ◽  
Hiv Care ◽  
Engagement In Care ◽  
Work Related ◽  
Medication Side ◽  
Competing Priorities ◽  
Lost To Follow Up

Abstract Background Regular follow-up HIV-infected patients on antiretroviral therapy (ART) is vital to ensure viral suppression, thus reducing HIV transmission, and HIV-related morbidity and mortality. However, some patients have been reported to have events of disengagement from care with subsequent re-engagement in care, though knowledge on the magnitude and determinants of this phenomenon, particularly in pastoralist communities is scarce. Methods A mixed-methods study was carried out among HIV-infected patients on antiretroviral therapy (ART) follow-up between January 2014 and June 2017 at the Baringo County Referral Hospital, Kabarnet, Kenya. Records on their clinic attendance and laboratory follow-up were extracted, and those noted to have a recent event of disengagement from care who later re-engaged in care, were then purposively sampled for in-depth interviews. Results 342 patient records were analyzed, of which 48% (166/342) of the patients were noted to be active at the end of the study period, with 63.3% (105/166) of them noted to have one or more events of disengagement from care. Female patients, patients with baseline CD4 counts ≥200 cells/mm3, and patients with a low WHO stage category (I and II) were more likely to return to care after an experience of disengagement from HIV care (P < 0.05). Eight interviewee transcripts showed the following reported reasons for disengagement in care: long distances, stigma, work-related problems, medication side effects, competing priorities, perceived recovery of the health status, medication fatigue, and not being informed of their clinic return dates. Motivators for re-engagement in care included hospital admissions, fear of getting sick like their spouse, and phone reminders. Conclusion A vast majority of patients currently active in care experienced multiple events of disengagement from care. Thus, early identification of those who disengage from care is recommended, before they become lost to follow-up. Disclosures All authors: No reported disclosures.

scholarly journals Re-engagement in care of people living with HIV lost to follow-up after initiation of antiretroviral therapy in Mali: Who returns to care?

PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0238687
Author(s):  
Aliou Baldé ◽  
Laurence Lièvre ◽  
Almoustapha Issiaka Maiga ◽  
Fodié Diallo ◽  
Issouf Alassane Maiga ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Engagement In Care ◽  
Living With Hiv ◽  
Lost To Follow Up

scholarly journals Factors associated with retention in HIV care at Sediba Hope Medical Centre

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Nishana Ramdas ◽  
Johanna C. Meyer ◽  
David Cameron
Keyword(s):  
Support Group ◽  
Retention In Care ◽  
Electronic System ◽  
Hiv Care ◽  
Work Related ◽  
Retention In Hiv Care ◽  
Close Proximity ◽  
Related Stress ◽  
Lost To Follow Up

Background: Lost to follow-up (LTFU) is a major challenge that hinders the success of antiretroviral treatment (ART).Objective: To identify factors conducted to a low LTFU rate.Methods: We conducted a two-part descriptive and quantitative study. Part 1 comprised interviews with clinic staff to determine their perspectives on LTFU and to establish the clinic’s follow-up procedures for patients on ART. Part 2 of the study was a retrospective review of clinic and patient records. LTFU patients were identified and those with contact details were contacted for telephonic interview to determine if they were still on ART and/or their reasons for becoming LTFU.Results: A low LTFU rate (7.9%; N = 683) was identified. Work-related stress, and lack of transport and funds were reported reasons for LTFU. Monthly visits, non-adherent defaulters and LTFU patients were tracked by an electronic system (SOZO). Factors contributing to high rates of retention in care were: location of the clinic in the inner city, thus in close proximity to patients’ homes or work; clinic operating on Saturdays, which was convenient for patients who could not attend during the week; an appointment/booking system that was in place and strictly adhered to; a reminder SMS being sent out the day before an appointment; individual counselling sessions at each visit and referrals where necessary; and a stable staff complement and support group at the clinic.Conclusion: Achieving a low LTFU rate is possible by having a patient-centred approach and monitoring systems in place.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

scholarly journals Using concept mapping to explore why patients become lost to follow up from an antiretroviral therapy program in the Zomba District of Malawi

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Beth Rachlis ◽  
Farah Ahmad ◽  
Monique van Lettow ◽  
Adamson S Muula ◽  
Medson Semba ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Concept Mapping ◽  
Therapy Program ◽  
Lost To Follow Up

scholarly journals Engagement in care among women and their infants lost to follow-up under Option B+ in eSwatini

PLoS ONE ◽  
2019 ◽  
Vol 14 (10) ◽  
pp. e0222959 ◽  
Author(s):  
William Reidy ◽  
Harriet Nuwagaba-Biribonwoha ◽  
Siphesihle Shongwe ◽  
Ruben Sahabo ◽  
Kieran Hartsough ◽  
...  
Keyword(s):  
Engagement In Care ◽  
Lost To Follow Up

scholarly journals Understanding Reasons for and Outcomes of Patients Lost to Follow-Up in Antiretroviral Therapy Programs in Africa Through a Sampling-Based Approach

2010 ◽  
Vol 53 (3) ◽  
pp. 405-411 ◽  
Author(s):  
Elvin H Geng ◽  
David R Bangsberg ◽  
Nicolas Musinguzi ◽  
Nneka Emenyonu ◽  
Mwebesa Bosco Bwana ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Lost To Follow Up

scholarly journals Outcomes of Patients Lost to Follow-up in African Antiretroviral Therapy Programs: Individual Patient Data Meta-analysis

2018 ◽  
Vol 67 (11) ◽  
pp. 1643-1652 ◽  
Author(s):  
Frédérique Chammartin ◽  
Kathrin Zürcher ◽  
Olivia Keiser ◽  
Ralf Weigel ◽  
Kathryn Chu ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Lost To Follow Up

Retaining HIV-positive patients in HIV care: a personalised approach for those at risk of loss to follow-up at an inner city sexual health service

Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 91
Author(s):  
Loretta Healey ◽  
Catherine C. O'Connor
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Text Messages ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Patients ◽  
Loss To Follow Up ◽  
Sexual Health Service ◽  
Lost To Follow Up

In 2013 a personalised approach to follow-up of HIV patients who had withdrawn from HIV care was taken at RPA Sexual Health, a Sydney metropolitan sexual health service. HIV patients were telephoned, sent text messages, emailed and sent letters multiple times where applicable. With this intervention 20 of 23 people who had withdrawn from HIV care re-engaged. Since that time, active follow-up of all people diagnosed with HIV has resulted in only 2% of HIV patients at RPA Sexual Health being lost to follow-up.

scholarly journals WYZ: Results of a pilot study of a mobile health application for engagement in care and antiretroviral therapy adherence among youth and young adults living with HIV (Preprint)

2020 ◽  
Author(s):  
Parya Saberi ◽  
Nadra E. Lisha ◽  
Xavier A. Erguera ◽  
Estie S. Hudes ◽  
Mallory O. Johnson ◽  
...  
Keyword(s):  
Young Adults ◽  
Antiretroviral Therapy ◽  
San Francisco ◽  
Mobile Health ◽  
Pilot Trial ◽  
Hiv Care ◽  
Art Adherence ◽  
Engagement In Care ◽  
Youth And Young Adults ◽  
Living With Hiv

BACKGROUND Youth are globally recognized as being vulnerable to HIV. Younger age has been correlated with worse health outcomes. Mobile health (mHealth) delivered interventions have the potential to meet youth where they are, using a device they already access. OBJECTIVE Using pre-defined benchmarks, we sought to evaluate the feasibility and acceptability of WYZ, an mHealth application, for improved engagement in care and antiretroviral therapy (ART) adherence among youth and young adults living with HIV (YLWH). WYZ was designed and developed with input from YLWH using a Human-Centered Design approach and based on the Information, Motivation, Behavioral Skills framework to address common barriers to care and ART adherence among YLWH. METHODS We recruited YLWH (18–29 years old) in the San Francisco Bay Area to take part in a six-month pilot trial. Their participation included completing a baseline and exit survey and participating in seven phone check-ins about their use of WYZ. RESULTS YLWH (N= 79) reported high levels of feasibility and acceptability with WYZ use. We met pre-defined benchmarks for recruitment, mean log-ins per week, tracking ART adherence, posting chat topics, and app crashes reported. Ease of app download, install, and set up, as well as comfort with security, privacy, and anonymity were highly rated. Additionally, participants reported high satisfaction for a research project that was remotely conducted. Participants used the app for shorter timeframes compared to the pre-defined benchmarks. CONCLUSIONS We noted high feasibility and acceptability with WYZ. Further research to examine the efficacy of WYZ will enable YLWH and their providers to make informed decisions when using, recommending, and prescribing it for improved engagement in HIV care and ART adherence. CLINICALTRIAL NCT03587857

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