title: Factors associated with loss-to-follow-up during behavioral interventions and HIV testing cohort among men who have sex with men in Nanjing, China.
abstract: BACKGROUND
  Behavioral interventions (BIs) remained the cornerstone of HIV prevention in resource-limited settings. One of the major concerns for such efforts is the loss-to-follow-up (LTFU) that threatens almost every HIV control program involving high-risk population groups.
  
  
  METHODS
  To evaluate the factors associated with LTFU during BIs and HIV testing among men who have sex with men (MSM), 410 HIV sero-negatives MSM were recruited using respondent driven sampling (RDS) in Nanjing, China during 2008, they were further followed for 18 months. At baseline and each follow-up visits, each participant was counseled about various HIV risk-reductions BIs at a designated sexually transmitted infection (STI) clinic.
  
  
  RESULTS
  Among 410 participants recruited at baseline, altogether 221 (53.9%) were LTFU at the 18-month follow-up visit. Overall, 46 participants were found to be positive for syphilis infection at baseline while 13 participants were HIV sero-converted during the follow-up period. Increasing age was less (Adjusted Odds Ratio(aOR) of 0.90, 95% confidence Interval (CI) 0.86-0.94) and official residency of provinces other than Nanjing (AOR of 2.49, 95%CI 1.32-4.71), lower level of education (AOR of 2.01, 95%CI 1.10-3.66) and small social network size (AOR of 1.75, 95%CI 1.09-2.80) were more likely to be associated with higher odds of LTFU.
  
  
  CONCLUSIONS
  To improve retention in the programs for HIV control, counseling and testing among MSM in Nanjing, focused intensified intervention targeting those who were more likely to be LTFU, especially the young, less educated, unofficial residents of Nanjing who had smaller social network size, might be helpful.
authors.affiliation: Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, Guangdong, 510095, China; Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China; University of North Carolina Project-China, Number 2 Lujing Road, Guangzhou, 510095, China.
authors.forename: Weiming
authors.initials: W
authors.lastname: Tang
authors.affiliation: Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Huan
authors.affiliation: Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, Guangdong, 510095, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, School National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
authors.forename: Tanmay
authors.initials: T
authors.lastname: Mahapatra
authors.affiliation: Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
authors.affiliation: Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, School National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
authors.forename: Sanchita
authors.initials: S
authors.lastname: Mahapatra
authors.affiliation: Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China.
authors.forename: Hongjing
authors.initials: H
authors.lastname: Yan
authors.affiliation: Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China.
authors.forename: Gengfeng
authors.initials: G
authors.lastname: Fu
authors.affiliation: Strategy, Investment and Impact Division, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
authors.forename: Jinkou
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China.
authors.forename: Chenghua
authors.initials: C
authors.lastname: Gu
authors.affiliation: Department of Epidemiology, School National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D001521:Behavior Therapy / Q000379:methods*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D004522:Educational Status; D015658:HIV Infections / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000208:ethnology / Q000706:statistics & numerical data*; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D055815:Young Adult