Limits...
Retention of antiretroviral naïve patients registered in HIV care in a program clinic in Pune, India.

Ghate MV, Zirpe SS, Gurav NP, Rewari BB, Gangakhedkar RR, Paranjape RS - Indian J Sex Transm Dis (2014 Jul-Dec)

Bottom Line: The multivariate analysis showed that baseline CD4 count >350 cells/mm(3) (P < 0.01) and illiteracy (P = 0.044) were significantly associated with LFU.Higher CD4 count and illiteracy were significantly associated with lower retention in pre-ART care.Developing effective "retention package" for patients and strengthening linkage strategies between key sub-population such as FSWs and ART programming will help to plug the leaky cascade in HIV care.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, National AIDS Research Institute, Pune, India.

ABSTRACT

Background: Retention in HIV care ensures delivery of services like secondary prevention, timely initiation of treatment, support, and care on a regular basis. The data on retention in pre antiretroviral therapy (ART) care in India is scanty.

Materials and methods: Antiretroviral naïve HIV-infected adult patients registered between January 2011 and March 2012 in HIV care (pre-ART) were included in the study. The follow-up procedures were done as per the national guidelines. Patients who did not report to the clinic for 1 year were considered as pre-ART lost to follow-up (pre-ART LFU). They were contacted either telephonically or by home visits. Logistic regression analysis was done to find out factors associated with pre-ART loss to follow-up.

Results: A total of 689 antiretroviral naïve adult patients were registered in the HIV care. Fourteen (2%) patients died and 76 (11%) were LFU till March 2013. The multivariate analysis showed that baseline CD4 count >350 cells/mm(3) (P < 0.01) and illiteracy (P = 0.044) were significantly associated with LFU. Of the total pre-ART LFUs, 35 (46.1%) informed that they would visit the clinic at their convenient time. NGOs that referred 16 female sex workers (FSWs) who were LFU (21.1%) informed that they would make efforts to refer them to the clinic.

Conclusion: Higher CD4 count and illiteracy were significantly associated with lower retention in pre-ART care. Developing effective "retention package" for patients and strengthening linkage strategies between key sub-population such as FSWs and ART programming will help to plug the leaky cascade in HIV care.

No MeSH data available.


Related in: MedlinePlus

Outcome of contact information among lost to follow-up patients (n = 76) at the program clinic in Pune
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553840&req=5

Figure 1: Outcome of contact information among lost to follow-up patients (n = 76) at the program clinic in Pune

Mentions: The data on telephonic contact and home visits among LFU patients are shown in [Figure 1]. It was observed that 35 (46.1%) patients informed that they would visit the clinic as per their convenience. Four NGOs who had referred 16 (21.1%) FSWs informed that they would make efforts to motivate them for follow-up, 12 patients (15.8%) had left the city either for work or permanently, 5 (6.6%) were registered in other ART centres, 3 (3.9%) were not interested in follow-up, 4 (5.3%) had given wrong addresses, and 1 (1.3%) had expired. Of the 35 patients who informed that they would visit the clinic, 25 had baseline CD4 count >350 cells/mm3 while 8 had CD4 count <350 cells/mm3. The CD4 count could not be obtained for two patients.


Retention of antiretroviral naïve patients registered in HIV care in a program clinic in Pune, India.

Ghate MV, Zirpe SS, Gurav NP, Rewari BB, Gangakhedkar RR, Paranjape RS - Indian J Sex Transm Dis (2014 Jul-Dec)

Outcome of contact information among lost to follow-up patients (n = 76) at the program clinic in Pune
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553840&req=5

Figure 1: Outcome of contact information among lost to follow-up patients (n = 76) at the program clinic in Pune
Mentions: The data on telephonic contact and home visits among LFU patients are shown in [Figure 1]. It was observed that 35 (46.1%) patients informed that they would visit the clinic as per their convenience. Four NGOs who had referred 16 (21.1%) FSWs informed that they would make efforts to motivate them for follow-up, 12 patients (15.8%) had left the city either for work or permanently, 5 (6.6%) were registered in other ART centres, 3 (3.9%) were not interested in follow-up, 4 (5.3%) had given wrong addresses, and 1 (1.3%) had expired. Of the 35 patients who informed that they would visit the clinic, 25 had baseline CD4 count >350 cells/mm3 while 8 had CD4 count <350 cells/mm3. The CD4 count could not be obtained for two patients.

Bottom Line: The multivariate analysis showed that baseline CD4 count >350 cells/mm(3) (P < 0.01) and illiteracy (P = 0.044) were significantly associated with LFU.Higher CD4 count and illiteracy were significantly associated with lower retention in pre-ART care.Developing effective "retention package" for patients and strengthening linkage strategies between key sub-population such as FSWs and ART programming will help to plug the leaky cascade in HIV care.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, National AIDS Research Institute, Pune, India.

ABSTRACT

Background: Retention in HIV care ensures delivery of services like secondary prevention, timely initiation of treatment, support, and care on a regular basis. The data on retention in pre antiretroviral therapy (ART) care in India is scanty.

Materials and methods: Antiretroviral naïve HIV-infected adult patients registered between January 2011 and March 2012 in HIV care (pre-ART) were included in the study. The follow-up procedures were done as per the national guidelines. Patients who did not report to the clinic for 1 year were considered as pre-ART lost to follow-up (pre-ART LFU). They were contacted either telephonically or by home visits. Logistic regression analysis was done to find out factors associated with pre-ART loss to follow-up.

Results: A total of 689 antiretroviral naïve adult patients were registered in the HIV care. Fourteen (2%) patients died and 76 (11%) were LFU till March 2013. The multivariate analysis showed that baseline CD4 count >350 cells/mm(3) (P < 0.01) and illiteracy (P = 0.044) were significantly associated with LFU. Of the total pre-ART LFUs, 35 (46.1%) informed that they would visit the clinic at their convenient time. NGOs that referred 16 female sex workers (FSWs) who were LFU (21.1%) informed that they would make efforts to refer them to the clinic.

Conclusion: Higher CD4 count and illiteracy were significantly associated with lower retention in pre-ART care. Developing effective "retention package" for patients and strengthening linkage strategies between key sub-population such as FSWs and ART programming will help to plug the leaky cascade in HIV care.

No MeSH data available.


Related in: MedlinePlus