Factors associated with retention to care in an HIV clinic in Gabon, Central Africa

 

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dc.contributor.author Janssen, Saskia en_ZA
dc.contributor.author Wieten, Rosanne Willemijn en_ZA
dc.contributor.author Stolp, Sebastiaan en_ZA
dc.contributor.author Cremers, Anne Lia en_ZA
dc.contributor.author Rossatanga, Elie Gide en_ZA
dc.contributor.author Klipstein-Grobusch, Kerstin en_ZA
dc.contributor.author Belard, Sabine en_ZA
dc.contributor.author Grobusch, Martin Peter en_ZA
dc.date.accessioned 2015-12-20T16:05:18Z
dc.date.available 2015-12-20T16:05:18Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Janssen, S., Wieten, R. W., Stolp, S., Cremers, A. L., Rossatanga, E. G., Klipstein-Grobusch, K., ... & Grobusch, M. P. (2015). Factors associated with retention to care in an HIV clinic in Gabon, Central Africa. PloS one, 10(10), e0140746. doi:10.1371/journal.pone.0140746 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15919
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0140746
dc.description.abstract BACKGROUND: Retention to HIV care is vital for patients' survival, to prevent onward transmission and emergence of drug resistance. Travelling to receive care might influence adherence. Data on the functioning of and retention to HIV care in the Central African region are limited. METHODS: This retrospective study reports outcomes and factors associated with retention to HIV care at a primary HIV clinic in Lambaréné, Gabon. Adult patients who presented to this clinic between January 2010 and January 2012 were included. Outcomes were retention in care (defined as documented show-up for clinical visits, regardless of delay) or LTFU (defined as a patient not retained in care; on ART or ART naïve, not returning to care during the study period with a patient delay for scheduled visits of more than 6 months), and mortality. Cox regression analysis was used to assess factors associated with respective outcomes. Qualitative data on reasons for LTFU were obtained from focus-group discussions. RESULTS: Of 223 patients included, 67.3% were female. The mean age was 40.5 (standard deviation 11.4) years and the median CD4 count 275 (interquartile range 100.5-449.5) cells/μL. In total, 34.1% were lost to follow up and 8.1% died. Documented tuberculosis was associated with increased risk of being LTFU (adjusted hazard ratio (aHR) 1.80, 95% confidence interval (95% CI) 1.05-3.11, P = 0.03), whereas early starting anti-retroviral therapy (ART) was associated with a decreased risk of LTFU (aHR 0.43, 95%CI 0.24-0.76, P = 0.004), as was confirmed by qualitative data. CONCLUSIONS: Retention to HIV care in a primary clinic in Gabon is relatively poor and interventions to address this should be prioritized in the HIV program. Early initiation of ART might improve retention in care. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other HIV en_ZA
dc.subject.other Gabon en_ZA
dc.subject.other Tuberculosis en_ZA
dc.subject.other Adults en_ZA
dc.subject.other Physicians en_ZA
dc.subject.other HIV epidemiology en_ZA
dc.subject.other Multivariate analysis en_ZA
dc.subject.other Transportation en_ZA
dc.title Factors associated with retention to care in an HIV clinic in Gabon, Central Africa en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2015 Janssen et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Institute of Infectious Disease and Molecular Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Janssen, S., Wieten, R. W., Stolp, S., Cremers, A. L., Rossatanga, E. G., Klipstein-Grobusch, K., ... Grobusch, M. P. (2015). Factors associated with retention to care in an HIV clinic in Gabon, Central Africa. <i>PLoS One</i>, http://hdl.handle.net/11427/15919 en_ZA
dc.identifier.chicagocitation Janssen, Saskia, Rosanne Willemijn Wieten, Sebastiaan Stolp, Anne Lia Cremers, Elie Gide Rossatanga, Kerstin Klipstein-Grobusch, Sabine Belard, and Martin Peter Grobusch "Factors associated with retention to care in an HIV clinic in Gabon, Central Africa." <i>PLoS One</i> (2015) http://hdl.handle.net/11427/15919 en_ZA
dc.identifier.vancouvercitation Janssen S, Wieten RW, Stolp S, Cremers AL, Rossatanga EG, Klipstein-Grobusch K, et al. Factors associated with retention to care in an HIV clinic in Gabon, Central Africa. PLoS One. 2015; http://hdl.handle.net/11427/15919. en_ZA
dc.identifier.ris TY - Journal Article AU - Janssen, Saskia AU - Wieten, Rosanne Willemijn AU - Stolp, Sebastiaan AU - Cremers, Anne Lia AU - Rossatanga, Elie Gide AU - Klipstein-Grobusch, Kerstin AU - Belard, Sabine AU - Grobusch, Martin Peter AB - BACKGROUND: Retention to HIV care is vital for patients' survival, to prevent onward transmission and emergence of drug resistance. Travelling to receive care might influence adherence. Data on the functioning of and retention to HIV care in the Central African region are limited. METHODS: This retrospective study reports outcomes and factors associated with retention to HIV care at a primary HIV clinic in Lambaréné, Gabon. Adult patients who presented to this clinic between January 2010 and January 2012 were included. Outcomes were retention in care (defined as documented show-up for clinical visits, regardless of delay) or LTFU (defined as a patient not retained in care; on ART or ART naïve, not returning to care during the study period with a patient delay for scheduled visits of more than 6 months), and mortality. Cox regression analysis was used to assess factors associated with respective outcomes. Qualitative data on reasons for LTFU were obtained from focus-group discussions. RESULTS: Of 223 patients included, 67.3% were female. The mean age was 40.5 (standard deviation 11.4) years and the median CD4 count 275 (interquartile range 100.5-449.5) cells/μL. In total, 34.1% were lost to follow up and 8.1% died. Documented tuberculosis was associated with increased risk of being LTFU (adjusted hazard ratio (aHR) 1.80, 95% confidence interval (95% CI) 1.05-3.11, P = 0.03), whereas early starting anti-retroviral therapy (ART) was associated with a decreased risk of LTFU (aHR 0.43, 95%CI 0.24-0.76, P = 0.004), as was confirmed by qualitative data. CONCLUSIONS: Retention to HIV care in a primary clinic in Gabon is relatively poor and interventions to address this should be prioritized in the HIV program. Early initiation of ART might improve retention in care. DA - 2015 DB - OpenUCT DO - 10.1371/journal.pone.0140746 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Factors associated with retention to care in an HIV clinic in Gabon, Central Africa TI - Factors associated with retention to care in an HIV clinic in Gabon, Central Africa UR - http://hdl.handle.net/11427/15919 ER - en_ZA


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.