Details:

Alternative Title:
PLoS One
Personal Author:
Puttkammer, Nancy ; Domerçant, Jean Wysler ; Adler, Michelle ; Yuhas, Krista ; Myrtil, Martine ; ... More +
Puttkammer, Nancy ; Domerçant, Jean Wysler ; Adler, Michelle ; Yuhas, Krista ; Myrtil, Martine ; Young, Paul ; François, Kesner ; Grand’Pierre, Reynold ; Lowrance, David Less -
Description:
Objectives

In October 2012, the Haitian Ministry of Health endorsed the “Option B+” strategy to eliminate mother-to-child transmission of HIV and achieve HIV epidemic control. The objective of this paper is to assess and identify risk factors for attrition from the national ART program among Option B+ patients in the 12 months after ART initiation.

Design

This retrospective cohort study included patients newly initiating ART from October 2012-August 2013 at 68 ART sites covering 45% of all newly enrolled ART patients in all regions of Haiti.

Methods

With data from electronic medical records, we carried out descriptive analysis of sociodemographic, clinical, and pregnancy-related correlates of ART attrition, and used a modified Poisson regression approach to estimate relative risks in a multivariable model.

Results

There were 2,166 Option B+ patients who initiated ART, of whom 1,023 were not retained by 12 months (47.2%). One quarter (25.3%) dropped out within 3 months of ART initiation. Protective factors included older age, more advanced HIV disease progression, and any adherence counseling prior to ART initiation, while risk factors included starting ART late in gestation, starting ART within 7 days of HIV testing, and using an atypical ART regimen.

Discussion

Our study demonstrates early ART attrition among Option B+ patients and contributes evidence on the characteristics of women who are most at risk of attrition in Haiti. Our findings highlight the importance of targeted strategies to support retention among Option B+ patients.


Subjects:
[+]
Antiretroviral Therapy, Highly Active Female HIV Infections Humans Male Odds Ratio Population Surveillance Pregnancy Retrospective Studies Risk Factors Treatment Outcome
Source:
PLoS One. 12(3).
Pubmed ID:
28264045
Pubmed Central ID:
PMC5338795
Document Type:
Journal Article
Place as Subject:
Haiti
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:da89a394fa902b8d37d87eca0c7b8885b2be46a43721fc88c31a1940e39531c9
Download URL:
https://stacks.cdc.gov/view/cdc/44823/cdc_44823_DS1.pdf
File Type:

Supporting Files

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