title: Seven year review of retention in HIV care and treatment in federal medical centre Ido-Ekiti.
abstract: BACKGROUND
  Poor retention of patients in care is a major driver of poor performance and increased morbidity and mortality in HIV/AIDS programme despite the expansion and advancement Anti-retroviral Therapy (ART). The objective of this study is to assess retention rates and possible determining factors in People Living with HIV (PLHIV) on ART.
  
  
  METHODS
  This is a descriptive, cross-sectional study conducted in Federal Medical Center, Ido-Ekiti, Nigeria. Medical records of clients who were enrolled in ART Care and support unit (HIV Clinic) of the health facility from 2005 to 2012 were reviewed and analyzed using SPSS version 16. A total of 621 client records were reviewed for basic demographic information, CD4 count, WHO stage, number of follow-up visit, client ART status and client retention status (defined as client attending at least one clinic visit in 2012.
  
  
  RESULTS
  A total of 347(63%) patients were retained in care and 208(37%) were not retained over the seven year review period. Retention was statistically significant with age (P-value 0.031), ART status (P-value 0.000) baseline CD4 (P-value 0.004), year of diagnosis and ART initiation (P-value= 0.027). Poor retention was associated decreasing age, pre-ART client, HIV stage 1&IV client and baseline CD4 above 400cell/mm(3).
  
  
  CONCLUSIONS
  Retention in care of PLHIV is a minimum necessary condition for maintaining or restoring health in the long run. The strategies to sustain and improve retention rate should be adopted to maximize ART benefits. A follow-up study on other factors affecting retention from diagnosis to long term retention ART programme is recommended.
authors.affiliation: Department of Community Medicine, Federal Medical Center, PMB 201, Ido-Ekiti, Nigeria.
authors.forename: Oluwoleadeyemi
authors.initials: O
authors.lastname: Babatunde
authors.affiliation: Department of Community Medicine, Federal Medical Center, PMB 201, Ido-Ekiti, Nigeria.
authors.forename: Olujide John
authors.initials: OJ
authors.lastname: Ojo
authors.affiliation: Department of Community Medicine, Federal Medical Center, PMB 201, Ido-Ekiti, Nigeria.
authors.forename: Oladele Ademola
authors.initials: OA
authors.lastname: Atoyebi
authors.affiliation: Department of Community Medicine, Federal Medical Center, PMB 201, Ido-Ekiti, Nigeria.
authors.forename: David Sylvanus
authors.initials: DS
authors.lastname: Ekpo
authors.affiliation: Care and Support Unit, Department of Community Medicine, Federal Medical Center, PMB 201, Ido-Ekiti, Nigeria.
authors.forename: Adebusuyi Opeyemi
authors.initials: AO
authors.lastname: Ogundana
authors.affiliation: Department of Community Medicine, Federal Medical Center, PMB 201, Ido-Ekiti, Nigeria.
authors.forename: Temitope Oluseun
authors.initials: TO
authors.lastname: Olaniyan
authors.affiliation: Department of Community Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria.
authors.forename: John Adeyemi
authors.initials: JA
authors.lastname: Owoade
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010349:Patient Compliance / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; CD4; HIV; antiretroviral; retention