Estimating Retention in Care for HIV-Infected Patients on Antiretroviral Therapy in Africa
Author Information
Author(s): Geng Elvin H., Glidden David V., Bwana Mwebesa Bosco, Musinguzi Nicolas, Emenyonu Nneka, Muyindike Winnie, Christopoulos Katerina A., Neilands Torsten B., Yiannoutsos Constantin T., Deeks Steven G., Bangsberg David R., Martin Jeffrey N.
Primary Institution: University of California San Francisco
Hypothesis
Current estimates of retention among HIV-infected patients on antiretroviral therapy in Africa may underestimate actual retention due to silent transfers and early deaths.
Conclusion
Accounting for silent transfers and early deaths significantly increases estimates of patient retention and connection to care among HIV-infected patients.
Supporting Evidence
- Among 3,628 patients, 829 became lost, and 128 were tracked.
- Of the 111 tracked patients, 79 (71%) were found to be alive.
- Retention estimates increased from 82.3% to 90.9% after incorporating updated care information.
Takeaway
This study shows that many people who seem to drop out of HIV care might actually be getting help elsewhere, and we need to look closer to understand their situation.
Methodology
The study tracked a representative sample of lost patients in the community to obtain updated information about their care status and used probability weights to correct retention estimates.
Potential Biases
Patients may have reported ART use due to social desirability, and the tracker was not a medical provider, which could affect the accuracy of reported outcomes.
Limitations
The study's sample was not formally random, and outcomes were not ascertained for all patients, which may introduce bias.
Participant Demographics
The median age of participants was 35 years, with 61% being women.
Statistical Information
P-Value
0.02
Confidence Interval
95% CI: 80.9–83.7
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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