Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya
| Autor: | Daniel Ochieng, Constantin T. Yiannoutsos, Margaret Holdsworth, Vincent Ochieng-Ooko, Kara Wools-Kaloustian, John E. Sidle, Abraham Siika, Paula Braitstein, Sylvester Kimaiyo, Michael Owiti |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
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Adult Male Time Factors Population Psychological intervention Prevalence HIV Infections Sex Factors Acquired immunodeficiency syndrome (AIDS) Risk Factors Medicine Humans Lost to follow-up education Retrospective Studies education.field_of_study business.industry Incidence (epidemiology) Research Incidence Public Health Environmental and Occupational Health Retrospective cohort study Middle Aged medicine.disease Kenya Anti-Retroviral Agents Socioeconomic Factors Immunology Female Lost to Follow-Up business Demography |
| Popis: | 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, 50275 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. |
| Databáze: | OpenAIRE |
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