British Association for Sexual Health and HIV Scottish Investigation 2010–2011: reasons for non-attendance in individuals lost to follow-up for HIV care for more than 12 months in Scotland

2013 ◽  
Vol 24 (6) ◽  
pp. 481-484 ◽  
Author(s):  
B L Cullen ◽  
G Codere ◽  
L A Wallace ◽  
S Baguley ◽  
DJ Clutterbuck
Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 91
Author(s):  
Loretta Healey ◽  
Catherine C. O'Connor

In 2013 a personalised approach to follow-up of HIV patients who had withdrawn from HIV care was taken at RPA Sexual Health, a Sydney metropolitan sexual health service.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 With this intervention 20 of 23 people who had withdrawn from HIV care re-engaged.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.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew

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


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Aaloke Mody ◽  
Kombatende Sikombe ◽  
Laura K. Beres ◽  
Sandra Simbeza ◽  
Njekwa Mukamba ◽  
...  

2020 ◽  
Author(s):  
R. Jeffrey Edwards ◽  
Nyla Lyons ◽  
Wendy Samaroo-Francis ◽  
Leon-Omari Lavia ◽  
Isshad John ◽  
...  

Abstract Background: Patients who default from HIV care are usually poorly adherent to antiretroviral treatment which results in suboptimal viral suppression. The study evaluated the effect and cost of expanding an intervention using two Patient Tracers to track and return to care patients lost to follow up at a large HIV Clinic in Trinidad.Methods: Two Social Workers were trained as Patient Tracers and hired initially for 6 months (April –September 2017), then extended to 15 months (April 2017 – June 2018) to call patients who were lost to follow up for 30 days or more during the period July 2016 – May 2018 at the HIV Clinic Medical Research Foundation of Trinidad and Tobago. Both the outcomes of the intervention, and costs were assessed over time. Results: Over the 15 month period, of the of 2,473 patients who missed their scheduled visits for one month or more, 261 (10.6%) patients were no longer in active care - 89 patients dead, 65 migrated, 55 hospitalized, 33 transferred to another treatment clinic and 19 incarcerated. Of the remaining 2,212 patients eligible for tracing, 1,794 (81.1%) patients were returned to care at an average cost of $38.09 USD per patient returned to care as compared to 589 of 866 (68%) patients returned to care over the 6 month period (p < 0.001) at an estimated cost of $47.72 USD per patient returned to care (p<0.001). Of the 1,794 patients returned to care, 1,686 (94%) were re-initiated/started on anti-retroviral therapy and 72.7% of these were virally suppressed (viral load <1,000 copies/ml) as of December 2018.Conclusions: Patient Tracing is a feasible and effective intervention to identify and resolve the status of patients who are loss to follow up to bring these patients back into care with the aim of achieving viral suppression on antiretroviral therapy. Over time the effect of costs of patients returned to care demonstrated greater yields making patient tracing a sustainable intervention for programmes to identify and return patients to care.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S476-S477
Author(s):  
Paul Otieno Yonga ◽  
Stephen Kiplimo Kalya ◽  
Lutgarde Lynen ◽  
Tom Decroo

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.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
R. Jeffrey Edwards ◽  
Nyla Lyons ◽  
Wendy Samaroo-Francis ◽  
Leon-Omari Lavia ◽  
Isshad John ◽  
...  

Abstract Background Patients who default from HIV care are usually poorly adherent to antiretroviral treatment which results in suboptimal viral suppression. The study assessed the outcomes of retention in care and viral suppression by expansion of an intervention using two patient tracers to track patients lost to follow up at a large HIV clinic in Trinidad. Methods Two Social Workers were trained as patient tracers and hired for 15 months (April 2017–June 2018) to call patients who were lost to follow up for 30 days or more during the period July 2016–May 2018 at the HIV clinic Medical Research Foundation of Trinidad and Tobago. Results Over the 15-month period, of the of 2473 patients who missed their scheduled visits for 1 month or more, 261 (10.6%) patients were no longer in active care—89 patients dead, 65 migrated, 55 hospitalized, 33 transferred to another treatment clinic and 19 incarcerated. Of the remaining 2212 patients eligible for tracing, 1869 (84.5%) patients were returned to care, 1278 (68.6%) were virally unsuppressed (viral load > 200 copies/ml) and 1727 (92.4%) were re-initiated on ART. Twelve months after their return, 1341 (71.7%) of 1869 patients were retained in care and 1154 (86.1%) of these were virally suppressed. Multivariate analysis using logistic regression showed that persons were more likely to be virally suppressed if they were employed (OR, 1.39; 95% CI 1.07–1.80), if they had baseline CD4 counts < 200 cells/mm3 (OR, 1.71; 95% CI 1.26–2.32) and if they were retained in care at 12 months (OR, 2.48; 95% CI 1.90–3.24). Persons initiated on ART for 4–6 years (OR, 3.09; 95% CI 1.13–8.48,), 7–9 years (OR, 3.97; 95% CI 1.39–11.31), > 10 years (OR, 5.99; 95% CI 1.74–20.64 were more likely to be retained in care. Conclusions Patient Tracing is a feasible intervention to identify and resolve the status of patients who are loss to follow up and targeted interventions such as differentiated care models may be important to improve retention in care.


Author(s):  
Nishana Ramdas ◽  
Johanna C. Meyer ◽  
David Cameron

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.


PLoS Medicine ◽  
2018 ◽  
Vol 15 (8) ◽  
pp. e1002636 ◽  
Author(s):  
Arianna Zanolini ◽  
Kombatende Sikombe ◽  
Izukanji Sikazwe ◽  
Ingrid Eshun-Wilson ◽  
Paul Somwe ◽  
...  

2019 ◽  
Vol 147 ◽  
Author(s):  
T. Htun ◽  
K. W. Y. Kyaw ◽  
T. K. Aung ◽  
J. Moe ◽  
A. A. Mon ◽  
...  

AbstractRetaining adolescents (aged 10–19 years), living with HIV (ALHIV) on antiretroviral therapy (ART) is challenging. In Myanmar, 1269 ALHIV were under an Integrated HIV Care (IHC) Programme by June 2017 and their attrition (death and lost to follow-up) rates were not assessed before. We undertook a cohort study using routinely collected data of ALHIV enrolled into HIV care from July 2005 to June 2017 and assessed their attrition rates in June 2018 by time-to-event analysis. Of 1269 enrolled, 197(16%) and of 1054 initiated ART, 224 (21%) had an attrition defining event. The pre-ART and ART attrition rates were 21.8 (95% CI 19.0–25.1) and 6.4 (95% CI 5.6–7.3) per 100 person-years follow-up, respectively. The factors ‘at enrolment’ that were associated with higher hazards of attrition were: (1) WHO stage 3 or 4; (2) haemoglobin <10 gm/dl; (3) no documented CD4 cell counts, hepatitis B and C test results; and (4) injection drug use. Baseline hazards were high during the initial 1–2 years and after 5–6 years. The pre-ART and ART attrition rates in ALHIV were lower than those in Africa but higher than the children under IHC. This warrants designing and implementing additional care tailored to the needs of ALHIV under IHC.


2019 ◽  
Author(s):  
Hannelore Götz ◽  
Denise Twisk ◽  
Jannigje Smit ◽  
Jan Beek ◽  
Candace Breman ◽  
...  

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