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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Enrollment and retention of HIV discordant couples in Lusaka, Zambia
Journal of Acquired Immune Deficiency Syndromes, Volume 47, No. 1, Year 2008
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Description
BACKGROUND: Biased enrollment and attrition compromise the power of clinical trials and limit generalizability of findings. We identify predictors of enrollment and retention for HIV-discordant couples enrolled in prospective studies in Zambia. PRINCIPAL FINDINGS: A total of 1995 discordant couples were invited to enroll. Predictors of nonenrollment, loss to follow-up, and missed appointments were evaluated using multivariate models. MF couples were more likely to be eligible and to enroll and less likely to be lost to follow-up than FM couples. Substantial losses to follow-up occurred between testing and enrollment (21.3% of MF and 28.1% of FM) and between enrollment and the first follow-up visit (24.9% of MF and 30.5% of FM). Among MF and FM couples, residence far from the clinic, younger age, and women's age at first intercourse ≤17 years were predictive of attrition. No income, ≤2 lifetime sex partners, no history of sexually transmitted infection in women, and recent extramarital contact in their male partners predicted attrition in FM couples. CONCLUSIONS: Discordant couples are critical to observational studies and clinical trials to prevent male-to-female and female-to-male transmission. Retention biases must be taken into account during analysis. Run-in designs that delay randomization may improve retention in clinical trials. © 2008 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Kempf, Mirjam Colette
Zambia, Lusaka
Zambia-emory Hiv Research Project
United States, Birmingham
The University of Alabama at Birmingham
Allen, Susan A.
Zambia, Lusaka
Zambia-emory Hiv Research Project
United States, Atlanta
Rollins School of Public Health
Zulu, Isaac S.
Zambia, Lusaka
Zambia-emory Hiv Research Project
Zambia, Lusaka
University of Zambia School of Medicine
Kancheya, Nzali G.
Zambia, Lusaka
Zambia-emory Hiv Research Project
Zambia, Lusaka
University of Zambia School of Medicine
Stephenson, Rob B.
United States, Atlanta
Rollins School of Public Health
Brill, Ilene K.
Zambia, Lusaka
Zambia-emory Hiv Research Project
United States, Birmingham
The University of Alabama at Birmingham
Tichacek, Amanda C.
Zambia, Lusaka
Zambia-emory Hiv Research Project
United States, Atlanta
Rollins School of Public Health
Haworth, Alan
Zambia, Lusaka
Zambia-emory Hiv Research Project
Zambia, Lusaka
University of Zambia School of Medicine
Zambia, Lusaka
University Teaching Hospital Lusaka
Zambia, Lusaka
Zambian Ministry of Health
Chomba, Elwyn Nachanya
Zambia, Lusaka
Zambia-emory Hiv Research Project
Zambia, Lusaka
Zambian Ministry of Health
Statistics
Citations: 54
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1097/QAI.0b013e31815d2f3f
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Study Locations
Zambia
Participants Gender
Male
Female