| Autor: |
Fiori KP; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.; Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.; Community Health Systems Lab, Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA., Belli HM; New York University School of Medicine, New York, NY, USA., Lauria ME; Community Health Systems Lab, Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA., Hirschhorn LR; Community Health Systems Lab, Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA.; Northwestern University Feinberg School of Medicine, Chicago, USA., Schechter J; Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA., Hansman E; Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA., Rajshekhar N; Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA., Katin V; Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA.; Service de dermatologie et IST, Centre Hospitalier Universitaire (CHU) Kara, Kara, Togo., Gbeleou S; Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA., Grunitsky-Bekele M; Integrate Health/Santé Intégrée, Kara, Togo and New York, NY, USA., Pitche VP; Programme National de Lutte Contre le VIH/SIDA-IST, Lomé, Togo. |
| Abstrakt: |
To disseminate lessons learned from the implementation experience of a public-private sector partnership, we describe a comprehensive HIV/AIDS program including 5-year survival outcomes for individuals who initiated antiretroviral therapy (ART) treatment in Togo from 2010 to 2015. A retrospective case study analysis was conducted from a cohort of patients receiving ART at an HIV/AIDS care clinic in Kara Region, Togo. Kaplan-Meier curves with Log rank tests were used to compare estimated survival curves by demographic and clinical characteristics. Associations were described between survival probability and age, gender, World Health Organization (WHO) disease stage, and timing of ART initiation. Cox proportional hazard model was used to determine predictors of mortality. After approximately five-years since ART initiation (1780 days), there were 114 deaths, with a survival probability of 75.3% (95% CI: 70.3-80.6%). Participants with advanced WHO disease stage were more likely at risk of death relative to patients categorized as WHO Stage 1, with Stage 4 approximately 9 times more likely (aHR 9.22, 95% CI 4.29-19.84). Our study suggests that delivering comprehensive HIV care through a private-public partnership may serve as a model to expand and improve HIV/AIDS care as well as high quality primary care. |
