Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Loss to care and death before antiretroviral therapy in Durban, South Africa
Journal of Acquired Immune Deficiency Syndromes, Volume 51, No. 2, Year 2009
Notification
URL copied to clipboard!
Description
OBJECTIVE: To examine the loss to care and mortality rates before starting antiretroviral therapy (ART) among ART eligible HIV-infected patients in Durban, South Africa. DESIGN: Retrospective cohort study. METHODS: We reviewed data from ART eligible adults (∼18 years) at an urban HIV clinic that charges a monthly fee from July to December 2006. ART eligibility was based on CD4 count ≤200 cells per microliter or clinical criteria and a psychosocial assessment. Patients who did not start ART and were lost within 3 months were phoned. Correlates of loss to care were evaluated using logistic regression. RESULTS: During the study period, 501 patients registered for ART training. Mean time from initial CD4 count to first ART training was 3.6 months (interquartile range 2.3-3.9 months). Four hundred eight patients (81.4%) were in care and on ART at 3-month follow-up, and 11 (2.2%) were in care but had not initiated ART. Eighty-two ART eligible patients (16.4%) were lost before ART initiation. Of these, 28 (34.1%) had died; two thirds of deaths occurred before or within 2 months after the first ART training. Despite multiple attempts, 32 patients (39%) were unreachable by phone. Lower baseline CD4 counts (≤100 cells/μL) and unemployment were independently associated with being lost. CONCLUSIONS: Loss to care and death occur frequently before starting ART at an HIV clinic in Durban, South Africa. This delay from CD4 count to ART training, even among those with the lowest CD4 counts, highlights the need for interventions that improve linkage to care and prioritize ART initiation for those with low baseline CD4 counts. © 2009 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Bassett, Ingrid V.
United States, Boston
Massachusetts General Hospital
Wang, Bingxia
United States, Boston
Massachusetts General Hospital
Chetty, S.
South Africa, Durban
Mccord Hospital
Mazibuko, Matilda
South Africa, Durban
Mccord Hospital
Bearnot, Benjamin
South Africa, Durban
Mccord Hospital
United States, New York
Nyu Grossman School of Medicine
Giddy, Janet
South Africa, Durban
Mccord Hospital
Lu, Zhigang
United States, Boston
Massachusetts General Hospital
Losina, Elena
United States, Boston
Massachusetts General Hospital
United States, Boston
School of Public Health
Walensky, Rochelle P.
United States, Boston
Massachusetts General Hospital
United States, Boston
Brigham and Women's Hospital
United States, Cambridge
Harvard University
Freedberg, Kenneth A.
United States, Boston
Massachusetts General Hospital
United States, Cambridge
Harvard University
United States, Boston
School of Public Health
Statistics
Citations: 168
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1097/QAI.0b013e3181a44ef2
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa