title: Brief Report: Decentralizing ART Supply for Stable HIV Patients to Community-Based Distribution Centers: Program Outcomes From an Urban Context in Kinshasa, DRC.
abstract: Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centers among 2603 patients with HIV in Kinshasa, Democratic Republic of Congo, using a multilevel Poisson regression model. Death, loss to follow-up, and transfer out were 0.3%, 9.0%, and 0.7%, respectively, at 24 months. Overall attrition was 5.66/100 person-years. Patients with >3 years on ART, >500 cluster of differentiation type-4 count, body mass index >18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centers are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage.
authors: *Institute of Tropical Medicine Antwerp, Antwerp, Belgium; †Doctors Without Borders/Médecins Sans Frontières, Kinshasa, Democratic Republic of the Congo; ‡Réseau National des Organisations d'Assise Communautaires, Kinshasa, Democratic Republic of the Congo; §Ministry of Health, Kinshasa, Democratic Republic of the Congo; ‖Doctors Without Borders/Médecins Sans Frontières, Brussels, Belgium; and ¶World Health Organization, Geneva, Switzerland.
authors: Florian
authors: F
authors: Vogt
authors: Lucien
authors: L
authors: Kalenga
authors: Jean
authors: J
authors: Lukela
authors: Freddy
authors: F
authors: Salumu
authors: Ibrahim
authors: I
authors: Diallo
authors: Elena
authors: E
authors: Nico
authors: Emmanuel
authors: E
authors: Lampart
authors: Rafael
authors: R
authors: Van den Bergh
authors: Safieh
authors: S
authors: Shah
authors: Olumide
authors: O
authors: Ogundahunsi
authors: Rony
authors: R
authors: Zachariah
authors: Johan
authors: J
authors: Van Griensven
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000600:supply & distribution* / Q000627:therapeutic use*; D015331:Cohort Studies; D003695:Delivery of Health Care; D015023:Democratic Republic of the Congo; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014505:Urban Population; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents