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The relationship between adherence to clinic appointments and year-one mortality for newly enrolled HIV infected patients at a regional referral hospital in Western Kenya, January 2011–December 2012

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  • Alternative Title:
    AIDS Care
  • Personal Author:
  • Description:
    This retrospective cohort analysis was conducted to describe the association between adherence to clinic appointments and mortality, one year after enrollment into HIV care. We examined appointment-adherence for newly enrolled patients between January 2011 and December 2012 at a regional referral hospital in western Kenya. The outcomes of interest were patient default, risk factors for repeat default, and year-one risk of death. Of 582 enrolled patients, 258 (44%) were defaulters. GEE revealed that once having been defaulters, patients were significantly more likely to repeatedly default (OR 1.4; 95% CI 1.12-1.77), especially the unemployed (OR 1.43; 95% CI 1.07-1.91), smokers (OR 2.22; 95% CI 1.31-3.76), and those with no known disclosure (OR 2.17; 95% CI 1.42-3.3). Nineteen patients (3%) died during the follow-up period. Cox proportional hazards revealed that the risk of death was significantly higher among defaulters (HR 3.12; 95% CI 1.2-8.0) and increased proportionally to the rate of patient default; HR was 4.05 (95% CI1.38-11.81) and 4.98 (95% CI 1.45-17.09) for a cumulative of 4-60 and ≥60 days elapsed between all scheduled and actual clinic appointment dates, respectively. Risk factors for repeat default suggest a need to deliver targeted adherence programs.
  • Subjects:
  • Source:
    AIDS Care. 28(4):409-415.
  • Pubmed ID:
    26572059
  • Pubmed Central ID:
    PMC4821878
  • Document Type:
    Journal Article
  • Funding:
    U19 GH000041/GH/CGH CDC HHS/United States
  • Place as Subject:
    Kenya
  • Volume:
    28
  • Issue:
    4
  • Collection(s):
  • Main Document Checksum:
    urn:sha256:aab137a59c4f9fa565f6b63059c1a0eca6f6409061b4909dc74d0266c6741ac3
  • Download URL:
  • File Type:
    Filetype[PDF - 795.91 KB ]
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