Factors Influencing Retention in Care after Starting Antiretroviral Therapy in a Rural South African Programme
Author Information
Author(s): Tom H. Boyles, Lynne S. Wilkinson, Rory Leisegang, Gary Maartens
Primary Institution: University of Cape Town
Hypothesis
What factors predict loss to follow-up and mortality in a public-sector HIV and ART programme in rural South Africa?
Conclusion
The study found that serving a socioeconomically deprived rural population does not hinder successful ART delivery, and that pre-ART care can improve outcomes.
Supporting Evidence
- 82.4% of patients were in active care or had transferred elsewhere at the end of the study.
- Independent predictors of loss to follow-up included younger age and starting ART as an inpatient.
- Patients with more than 6 months of pre-ART care had lower rates of loss to follow-up.
Takeaway
This study shows that people in rural areas can get good HIV treatment if they have support and care before starting their medicine.
Methodology
Prospective cohort analysis of adults from a rural HIV care programme.
Potential Biases
Potential bias due to the reliance on community information for death ascertainment.
Limitations
The study may have residual confounding and relied on community reports for death ascertainment.
Participant Demographics
The population is predominantly black African and Xhosa speaking, with 90% living below the poverty line.
Statistical Information
P-Value
0.002
Confidence Interval
1.28 to 3.62
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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