Community-led interventions to re-engage people living with HIV into care in Pakistan.

Autor:	Elsfoury S; Department of Communicable Diseases Prevention and Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt., Mugisa B; Department of Communicable Diseases Prevention and Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt., Pasha MS; World Health Organization, Pakistan Country Office, Islamabad, Pakistan., Satti A; Association of People Living with HIV, Islamabad, Pakistan., Haider O; Association of People Living with HIV, Islamabad, Pakistan., Tariq U; Association of People Living with HIV, Islamabad, Pakistan., Alaama AS; Department of Communicable Diseases Prevention and Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt., Jamil MS; Department of Communicable Diseases Prevention and Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt., Hutin Y; Department of Communicable Diseases Prevention and Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt., Hermez J; Department of Communicable Diseases Prevention and Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit [East Mediterr Health J] 2024 Oct 01; Vol. 30 (9), pp. 603-611. Date of Electronic Publication: 2024 Oct 01.
DOI:	10.26719/2024.30.9.603
Abstrakt:	Background: By 2021, Pakistan had an estimated 210 000 people living with HIV (PLHIV), and 27% of those initiated into treatment in 2020 had disengaged from care within one year. Aim: We assessed the effectiveness of an intervention to re-engage PLHIV lost to follow-up into care in Pakistan. Methods: Between September 2020 and May 2021, the Association of People Living with HIV (APLHIV) implemented a search and rescue intervention for PLHIV lost to follow-up in 2 large treatment centres in Pakistan. The centre staff reviewed records to identify those not in care for > 6 months and from September 2020 to May 2021, the APLHIV tracked them through telephone calls and home visits to re-engage them into care. We used SAS version 9.4 to analyse the data and univariate logistic regression to identify factors associated with disengagement and becoming untraceable. Results: Among the 4184 PLHIV registered (74% male), 36% (1517) (83.9% male, 15.4% female, 0.7% transgender) had disengaged from care. APLHIV members tracked 696 (46%) of them; 295 (42%) were deceased and 325 (47%) were re-engaged into care. Reasons for disengagement were long distance from the ART centre or lack of resources (45%), injecting drug use (19%), adverse effects of antiretroviral therapy (9%), disinformation (9%), no male family member to accompany them to treatment centre after the death of husband (3%), and no reason given (15%). Injecting drug users and males were more likely to be lost to follow-up, and males were more likely to be untraceable. Conclusion: This community-led intervention successfully re-engaged many PLHIV into care. The community-led re-engagement intervention should be upscaled to reduce loss to care and follow-up in Pakistan, especially among injecting drug users and male PLHIV. (Copyright © Authors 2024; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)
Databáze:	MEDLINE
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