Exploring Estimates and Reasons for Lost to Follow Up among People Living with HIV on Antiretroviral Therapy in Kisumu County, Kenya

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Samba, Benard O. ; Lewis-Kulzer, Jayne ; Odhiambo, Francesca ; Juma, Eric ; Mulwa, Edwin ; Kadima, Julie ; Bukusi, Elizabeth A. ; Cohen, Craig R.
• 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 with at least one clinic visit between 1st September 2016 and 31st August 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 (IQR: 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% CI, 58.9%–71.1%]) followed by structural reasons (29.6% [95% CI, 24.1%–35.8%]) and clinic-based reasons (3.0% [95% CI, 1.4%–6.2).
  
  Conclusion:
  
  We found that over 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.
  
  
• Subjects:
  Adult Ambulatory Care Facilities Anti-HIV Agents Cross-Sectional Studies Female HIV Infections Humans Lost To Follow-Up Male Retrospective Studies
• Source:
  J Acquir Immune Defic Syndr. 90(2):146-153
• Pubmed ID:
  35213856
• Pubmed Central ID:
  PMC9203903
• Document Type:
  Journal Article
• Funding:
  NU2GGH001947/ImCDC/Intramural CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/
• Place as Subject:
  Kenya
• Volume:
  90
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:130fd376f3c4143c61c22f3866a0e6b1f6ce9a0209bc9a94035e687e976e9943
• Download URL:
  https://stacks.cdc.gov/view/cdc/119279/cdc_119279_DS1.pdf
• File Type:
  [PDF - 299.78 KB ]