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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Exploring Estimates and Reasons for Lost to Follow-Up Among People Living With HIV on Antiretroviral Therapy in Kisumu County, Kenya
Journal of Acquired Immune Deficiency Syndromes, Volume 90, No. 2, Year 2022
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Description
Background:A better understanding why people living with HIV (PLHIV) become lost to follow-up (LTFU) and determining who is LTFU in a program setting is needed to attain HIV epidemic control.Setting:This retrospective cross-sectional study used an evidence-sampling approach to select health facilities and LTFU patients from a large HIV program supporting 61 health facilities in Kisumu County, Kenya.Methods:Eligible PLHIV included adults 18 years and older with at least 1 clinic visit between September 1, 2016, and August 31, 2018, and were LTFU (no clinical contact for ≥90 days after their last expected clinic visit). From March to June 2019, demographic and clinical variables were collected from a sample of LTFU patient files at 12 health facilities. Patient care status and retention outcomes were determined through program tracing.Results:Of 787 LTFU patients selected and traced, 36% were male, median age was 30.5 years (interquartile range: 24.6-38.0), and 78% had their vital status confirmed with 560 (92%) alive and 52 (8%) deceased. Among 499 (89.0%) with a retention outcome, 233 (46.7%) had stopped care while 266 (53.3%) had self-transferred to another facility. Among those who had stopped care, psychosocial reasons were most common {65.2% [95% confidence interval (CI): 58.9 to 71.1]} followed by structural reasons [29.6% (95% CI: 24.1 to 35.8)] and clinic-based reasons [3.0% (95% CI: 1.4 to 6.2)].Conclusion:We found that more than half of patients LTFU were receiving HIV care elsewhere, leading to a higher overall patient retention rate than routinely reported. Similar strategies could be considered to improve the accuracy of reporting retention in HIV care. © 2022 Lippincott Williams and Wilkins. All rights reserved.
Authors & Co-Authors
Samba, Benard O.
Kenya, Nairobi
Kenya Medical Research Institute
Lewis-Kulzer, Jayne
United States, San Francisco
University of California, San Francisco
Odhiambo, Frank Akoth
Kenya, Nairobi
Kenya Medical Research Institute
Juma, Eric
Kenya, Nairobi
Kenya Medical Research Institute
Mulwa, Edwin
Kenya, Nairobi
Kenya Medical Research Institute
Kadima, Julie
Kenya, Nairobi
Kenya Medical Research Institute
Bukusi, Elizabeth Anne
Kenya, Nairobi
Kenya Medical Research Institute
Cohen, Craig R.
United States, San Francisco
University of California, San Francisco
United States, St. Louis
Washington University in St. Louis
Statistics
Citations: 1
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0000000000002942
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Kenya
Participants Gender
Male