title: Characteristics of antiretroviral therapy-naïve patients lost-to-care in HIV clinics in Democratic Republic of Congo, Cameroon, and Burundi.
abstract: Antiretroviral therapy (ART)-naïve patients are vulnerable to becoming lost-to-care (LTC) because they are not monitored as often as patients on treatment. We examined data from 19,461 HIV positive adults at 10 HIV clinics in Democratic Republic of Congo (DRC), Cameroon, and Burundi participating in the Phase 1 International epidemiologic Databases to Evaluate AIDS Central Africa (IeDEA-CA) study. Patients were LTC if they were ART-naïve and did not return within 7 months of the end of data collection. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with LTC. Of 5353 ART-naïve patients, 4420 (83%) were LTC and 933 (17%) were in-care. The odds of being LTC were greatest among patients from DRC (OR = 2.16, CI: 1.64-2.84, p < .0001), males (OR = 1.39, CI: 1.15-1.69, p = .0009), and ages 18-49 (OR = 1.45, CI: 1.16-1.82, p = .001). The odds of being LTC were least among patients with a WHO Clinical Stage of 1 or 2 (OR = 0.65, CI: 0.55-0.77, p < .0001) and in a perceived concordant relationship (OR = 0.61, CI: 0.43-0.87, p < .0001). LTC patients were more likely to have characteristics associated with higher risk for HIV transmission and progression. Many entered care at advanced stages and were less likely to know their partner's serostatus. Greater efforts to retain ART-naïve patients may increase earlier initiation of ART.
authors: a RTI International , Research Triangle Park , NC , USA.
authors: Kristen
authors: K
authors: Stolka
authors: a RTI International , Research Triangle Park , NC , USA.
authors: Jeniffer
authors: J
authors: Iriondo-Perez
authors: b Kinshasa School of Public Health (KSPH) , Hôpital Général de Kinshasa , Kinshasa-Gombe , Democratic Republic of Congo.
authors: Modeste
authors: M
authors: Kiumbu
authors: b Kinshasa School of Public Health (KSPH) , Hôpital Général de Kinshasa , Kinshasa-Gombe , Democratic Republic of Congo.
authors: Joseph
authors: J
authors: Atibu
authors: c Vindata Solutions , Yaounde , Cameroon.
authors: Innocent
authors: I
authors: Azinyue
authors: d Limbé Provincial Hospital , Limbé , Cameroon.
authors: Wilfred
authors: W
authors: Akam
authors: e Hôpital Militaire , Yaoundé , Cameroon.
authors: Ashue
authors: A
authors: Balimba
authors: f Hôpital Général de Yaoundé , Yaoundé , Cameroon.
authors: Brigitte
authors: B
authors: Mfangam Molu
authors: g ACS/AMO Congo , Kinshasa , Democratic Republic of Congo.
authors: Henri
authors: H
authors: Mukumbi
authors: h Centre Hospitalo-Universitaire de Kamenge , Bujumbura , Burundi.
authors: Theodore
authors: T
authors: Niyongabo
authors: h Centre Hospitalo-Universitaire de Kamenge , Bujumbura , Burundi.
authors: Christelle
authors: C
authors: Twizere
authors: a RTI International , Research Triangle Park , NC , USA.
authors: Jamie
authors: J
authors: Newman
authors: a RTI International , Research Triangle Park , NC , USA.
authors: Jennifer
authors: J
authors: Hemingway-Foday
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods / Q000706:statistics & numerical data; D002063:Burundi / Q000453:epidemiology; D002163:Cameroon / Q000453:epidemiology; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D016903:Drug Monitoring / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012307:Risk Factors
keywords: ART-naïve; Central Africa; HIV; lost-to-care