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

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dc.contributor.authorJanssen, Saskiaen_ZA
dc.contributor.authorWieten, Rosanne Willemijnen_ZA
dc.contributor.authorStolp, Sebastiaanen_ZA
dc.contributor.authorCremers, Anne Liaen_ZA
dc.contributor.authorRossatanga, Elie Gideen_ZA
dc.contributor.authorKlipstein-Grobusch, Kerstinen_ZA
dc.contributor.authorBelard, Sabineen_ZA
dc.contributor.authorGrobusch, Martin Peteren_ZA
dc.date.accessioned2015-12-20T16:05:18Z
dc.date.available2015-12-20T16:05:18Z
dc.date.issued2015en_ZA
dc.description.abstractBACKGROUND: 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.identifier.apacitationJanssen, 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/11427/15919en_ZA
dc.identifier.chicagocitationJanssen, 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/11427/15919en_ZA
dc.identifier.citationJanssen, 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.0140746en_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
dc.identifier.urihttp://hdl.handle.net/11427/15919
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0140746
dc.identifier.vancouvercitationJanssen 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.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2015 Janssen et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherGabonen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherPhysiciansen_ZA
dc.subject.otherHIV epidemiologyen_ZA
dc.subject.otherMultivariate analysisen_ZA
dc.subject.otherTransportationen_ZA
dc.titleFactors associated with retention to care in an HIV clinic in Gabon, Central Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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