dc.contributor.author
Janssen, Saskia
dc.contributor.author
Wieten, Rosanne Willemijn
dc.contributor.author
Stolp, Sebastiaan
dc.contributor.author
Cremers, Anne Lia
dc.contributor.author
Rossatanga, Elie Gide
dc.contributor.author
Klipstein-Grobusch, Kerstin
dc.contributor.author
Belard, Sabine
dc.contributor.author
Grobusch, Martin Peter
dc.date.accessioned
2018-06-08T03:25:15Z
dc.date.available
2015-11-20T11:14:27.634Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/15146
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-19334
dc.description.abstract
Background Retention to HIV care is vital for patients’ survival, to prevent
onward transmission and emergence of drug resistance. Travelling to receive
care might influence adherence. Data on the functioning of and retention to
HIV care in the Central African region are limited. Methods This retrospective
study reports outcomes and factors associated with retention to HIV care at a
primary HIV clinic in Lambaréné, Gabon. Adult patients who presented to this
clinic between January 2010 and January 2012 were included. Outcomes were
retention in care (defined as documented show-up for clinical visits,
regardless of delay) or LTFU (defined as a patient not retained in care; on
ART or ART naïve, not returning to care during the study period with a patient
delay for scheduled visits of more than 6 months), and mortality. Cox
regression analysis was used to assess factors associated with respective
outcomes. Qualitative data on reasons for LTFU were obtained from focus-group
discussions. Results Of 223 patients included, 67.3% were female. The mean age
was 40.5 (standard deviation 11.4) years and the median CD4 count 275
(interquartile range 100.5–449.5) cells/μL. In total, 34.1% were lost to
follow up and 8.1% died. Documented tuberculosis was associated with increased
risk of being LTFU (adjusted hazard ratio (aHR) 1.80, 95% confidence interval
(95% CI) 1.05–3.11, P = 0.03), whereas early starting anti-retroviral therapy
(ART) was associated with a decreased risk of LTFU (aHR 0.43, 95%CI 0.24–0.76,
P = 0.004), as was confirmed by qualitative data. Conclusions Retention to HIV
care in a primary clinic in Gabon is relatively poor and interventions to
address this should be prioritized in the HIV program. Early initiation of ART
might improve retention in care.
en
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Factors Associated with Retention to Care in an HIV Clinic in Gabon, Central
Africa
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
PLoS ONE. - 10 (2015), 10, Artikel Nr. e0140746
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0140746
dcterms.bibliographicCitation.url
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140746
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000023492
refubium.note.author
Der Artikel wurde in einer Open-Access-Zeitschrift publiziert.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000005681
dcterms.accessRights.openaire
open access