Document Detail


Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya.
MedLine Citation:
PMID:  20865073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the incidence of loss to follow-up in a treatment programme for people living with human immunodeficiency virus (HIV) infection in Kenya and to investigate how loss to follow-up is affected by gender.
METHODS: Between November 2001 and November 2007, 50 275 HIV-positive individuals aged ≥ 14 years (69% female; median age: 36.2 years) were enrolled in the study. An individual was lost to follow-up when absent from the HIV treatment clinic for > 3 months if on combination antiretroviral therapy (cART) or for > 6 months if not. The incidence of loss to follow-up was calculated using Kaplan-Meier methods and factors associated with loss to follow-up were identified by logistic and Cox multivariate regression analysis.
FINDINGS: Overall, 8% of individuals attended no follow-up visits, and 54% of them were lost to follow-up. The overall incidence of loss to follow-up was 25.1 per 100 person-years. Among the 92% who attended at least one follow-up visit, the incidence of loss to follow-up before and after starting cART was 27.2 and 14.0 per 100 person-years, respectively. Baseline factors associated with loss to follow-up included younger age, a long travel time to the clinic, patient disclosure of positive HIV status, high CD4+ lymphocyte count, advanced-stage HIV disease, and rural clinic location. Men were at an increased risk overall and before and after starting cART.
CONCLUSION: The risk of being lost to follow-up was high, particularly before starting cART. Men were more likely to become lost to follow-up, even after adjusting for baseline sociodemographic and clinical characteristics. Interventions designed for men and women separately could improve retention.
Authors:
Vincent Ochieng-Ooko; Daniel Ochieng; John E Sidle; Margaret Holdsworth; Kara Wools-Kaloustian; Abraham M Siika; Constantin T Yiannoutsos; Michael Owiti; Sylvester Kimaiyo; Paula Braitstein
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-04-16
Journal Detail:
Title:  Bulletin of the World Health Organization     Volume:  88     ISSN:  1564-0604     ISO Abbreviation:  Bull. World Health Organ.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2011-01-06     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7507052     Medline TA:  Bull World Health Organ     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  681-8     Citation Subset:  IM    
Affiliation:
United States Agency for International Development, Academic Model Providing Access To Healthcare Partnership, Eldoret, Kenya.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Retroviral Agents / administration & dosage,  therapeutic use*
Female
HIV Infections / drug therapy*,  epidemiology*
Humans
Incidence
Kenya
Lost to Follow-Up*
Male
Middle Aged
Retrospective Studies
Risk Factors
Sex Factors
Socioeconomic Factors
Time Factors
Grant Support
ID/Acronym/Agency:
U01-AI0669911/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents
Comments/Corrections

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