Loss to Follow-Up of Stable Antiretroviral Therapy Patients in a Decentralized Down-Referral Model of Care in Johannesburg, South Africa

2011 ◽  
Vol 58 (4) ◽  
pp. 429-432 ◽  
Author(s):  
Cara OʼConnor ◽  
Regina Osih ◽  
Ambereen Jaffer
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Model Of Care ◽  
Loss To Follow Up

scholarly journals The HIV care cascade for adolescents initiated on antiretroviral therapy in a health district of South Africa: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Roxanna Haghighat ◽  
Elona Toska ◽  
Nontuthuzelo Bungane ◽  
Lucie Cluver
Keyword(s):  
South Africa ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
Hiv Care ◽  
Loss To Follow Up ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Clinical Records

Abstract Background Little evidence exists to comprehensively estimate adolescent viral suppression after initiation on antiretroviral therapy in sub-Saharan Africa. This study examines adolescent progression along the HIV care cascade to viral suppression for adolescents initiated on antiretroviral therapy in South Africa. Methods All adolescents ever initiated on antiretroviral therapy (n=1080) by 2015 in a health district of the Eastern Cape, South Africa, were interviewed in 2014–2015. Clinical records were extracted from 52 healthcare facilities through January 2018 (including records in multiple facilities). Mortality and loss to follow-up rates were corrected for transfers. Predictors of progression through the HIV care cascade were tested using sequential multivariable logistic regressions. Predicted probabilities for the effects of significant predictors were estimated by sex and mode of infection. Results Corrected mortality and loss to follow-up rates were 3.3 and 16.9%, respectively. Among adolescents with clinical records, 92.3% had ≥1 viral load, but only 51.1% of viral loads were from the past 12 months. Adolescents on ART for ≥2 years (AOR 3.42 [95%CI 2.14–5.47], p< 0.001) and who experienced decentralised care (AOR 1.39 [95%CI 1.06–1.83], p=0.018) were more likely to have a recent viral load. The average effect of decentralised care on recent viral load was greater for female (AOR 2.39 [95%CI 1.29–4.43], p=0.006) and sexually infected adolescents (AOR 3.48 [95%CI 1.04–11.65], p=0.043). Of the total cohort, 47.5% were recorded as fully virally suppressed at most recent test. Only 23.2% were recorded as fully virally suppressed within the past 12 months. Younger adolescents (AOR 1.39 [95%CI 1.06–1.82], p=0.017) and those on ART for ≥2 years (AOR 1.70 [95%CI 1.12–2.58], p=0.013) were more likely to be fully viral suppressed. Conclusions Viral load recording and viral suppression rates remain low for ART-initiated adolescents in South Africa. Improved outcomes for this population require stronger engagement in care and viral load monitoring.

Patient Loss to Follow-Up Before Antiretroviral Therapy Initiation in Rural Mozambique

2014 ◽  
Vol 19 (4) ◽  
pp. 666-678 ◽  
Author(s):  
Monica da Silva ◽  
Meridith Blevins ◽  
C. William Wester ◽  
José Manjolo ◽  
Eurico José ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Loss To Follow Up ◽  
Therapy Initiation

scholarly journals Determinants of loss to follow-up among HIV positive patients receiving antiretroviral therapy in a test and treat setting: A retrospective cohort study in Masaka, Uganda

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0217606 ◽  
Author(s):  
Julius Kiwanuka ◽  
Jacinta Mukulu Waila ◽  
Methuselah Muhindo Kahungu ◽  
Jonathan Kitonsa ◽  
Noah Kiwanuka
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hiv Positive ◽  
Loss To Follow Up ◽  
Test And Treat
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