Same-Day Antiretroviral Therapy Initiation Hub Model at the Thai Red Cross Anonymous Clinic in Bangkok, Thailand: High Levels of Acceptability, Long-Term Retention, and Viral Load Suppression

2018 ◽  
Author(s):  
Pich Seekaew ◽  
Nipat Teeratakulpisarn ◽  
Pongsakorn Surapuchong ◽  
Somsong Teeratakulpisarn ◽  
Tippawan Pankam ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Red Cross ◽  
Viral Load Suppression ◽  
Therapy Initiation ◽  
Term Retention ◽  
Long Term Retention ◽  
Hub Model

scholarly journals Long-term retention and predictors of attrition for key populations receiving antiretroviral treatment through community-based ART in Benue State Nigeria: A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260557
Author(s):  
Olujuwon Ibiloye ◽  
Plang Jwanle ◽  
Caroline Masquillier ◽  
Sara Van Belle ◽  
Ekere Jaachi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Key Populations ◽  
Community Based ◽  
Term Retention ◽  
Community Based Art ◽  
Long Term Retention

Background Key populations (KP) are disproportionately infected with HIV and experience barriers to HIV care. KP include men who have sex with men (MSM), female sex workers (FSW), persons who inject drugs (PWID) and transgender people (TG). We implemented three different approaches to the delivery of community-based antiretroviral therapy for KP (KP-CBART) in Benue State Nigeria, including One Stop Shop clinics (OSS), community drop-in-centres (DIC), and outreach venues. OSS are community-based health facilities serving KP only. DIC are small facilities led by lay healthcare providers and supported by an outreach team. Outreach venues are places in the community served by the outreach team. We studied long-term attrition of KP and virological non-suppression. Method This is a retrospective cohort study of KP living with HIV (KPLHIV) starting ART between 2016 and 2019 in 3 0SS, 2 DIC and 8 outreach venues. Attrition included lost to follow-up (LTFU) and death. A viral load >1000 copies/mL showed viral non-suppression. Survival analysis was used to assess retention on ART. Cox regression and Firth logistic regression were used to assess risk factors for attrition and virological non-suppression respectively. Result Of 3495 KPLHIV initiated on ART in KP-CBART, 51.8% (n = 1812) were enrolled in OSS, 28.1% (n = 982) in DIC, and 20.1% (n = 701) through outreach venues. The majority of participants were FSW—54.2% (n = 1896), while 29.8% (n = 1040), 15.8% (n = 551) and 0.2% (n = 8) were MSM, PWID, and TG respectively. The overall retention in the programme was 63.5%, 55.4%, 51.2%, and 46.7% at 1 year, 2 years, 3 years, and 4 years on ART. Of 1650 with attrition, 2.5% (n = 41) died and others were LTFU. Once adjusted for other factors (age, sex, place of residence, year of ART enrollment, WHO clinical stage, type of KP group, and KP-CBART approach), KP-CBART approach did not predict attrition. MSM were at a higher risk of attrition (vs FSW; adjusted hazard ratio (aHR) 1.27; 95%CI: 1.14–1.42). Of 3495 patients, 48.4% (n = 1691) had a viral load test. Of those, 97.8% (n = 1654) were virally suppressed. Conclusion Although long-term retention in care is low, the virological suppression was optimal for KP on ART and retained in community-based ART care. However, viral load testing coverage was sub-optimal. Future research should explore the perspectives of clients on reasons for LTFU and how to adapt approach to CBART to meet individual client needs.

scholarly journals Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study

PLoS ONE ◽  
2019 ◽  
Vol 14 (11) ◽  
pp. e0224837 ◽  
Author(s):  
Catrina Mugglin ◽  
Andreas D. Haas ◽  
Joep J. van Oosterhout ◽  
Malango Msukwa ◽  
Lyson Tenthani ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Term Retention ◽  
Adolescents And Adults ◽  
Long Term Retention

scholarly journals Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study

2019 ◽  
Author(s):  
Catrina Mugglin ◽  
Andreas Haas ◽  
Joep van Oosterhout ◽  
Malango Msukwa ◽  
Lyson Tenthani ◽  
...  
Keyword(s):  
Young Adults ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Early Years ◽  
First Year ◽  
Term Retention ◽  
Number Of Patients ◽  
Long Term Retention

Objectives: We examine long-term retention of adults, adolescents and children on antiretroviral therapy under different HIV treatment guidelines in Malawi. Design: Prospective cohort study. Setting and participants: Adults and children starting ART between 2005 and 2015 in 21 health facilities in southern Malawi. Methods: We used survival analysis to assess retention at clinic level, Cox regression to examine risk factors for loss to follow up, and competing risk analysis to assess long-term outcomes of people on antiretroviral therapy (ART). Results: We included 132,274 individuals in our analysis, totalling 270,256 person years of follow up (PYFU; median per patient 1.3, interquartile range (IQR) 0.26-3.1), 62% were female and the median age was 32 years. Retention on ART was lower in the first year on ART compared to subsequent years for all guideline periods and age groups. Infants (0-3 years), adolescents and young adults (15-24 years) were at highest risk of LTFU. Comparing the different calendar periods of ART initiation we found that retention improved initially, but remained stable thereafter. Conclusion: Even though the number of patients and the burden on health care system increased substantially during the study period of rapid ART expansion, retention on ART improved in the early years of ART provision, but gains in retention were not maintained over 5 years on ART. Reducing high attrition in the first year of ART should remain a priority for ART programs, and so should addressing poor retention among adolescents, young adults and men.

scholarly journals ART adherence clubs: A long-term retention strategy for clinically stable patients receiving antiretroviral therapy

2013 ◽  
Vol 14 (2) ◽  
pp. 48-50 ◽  
Author(s):  
Lynne Susan Wilkinson
Keyword(s):  
Antiretroviral Therapy ◽  
Art Adherence ◽  
Western Cape ◽  
Similar Model ◽  
Retention Strategy ◽  
Healthcare Facilities ◽  
Term Retention ◽  
Long Term Retention ◽  
Facility Staff

The ART-adherence club model described here provides patient-friendly access to antiretroviral therapy (ART) for clinically stable patients. It reduces the burden that stable patients place on healthcare facilities, increasing clinical human resources for new patients, and those clinically unstable and at risk of failing treatment. In the model, 30 patients are allocated to an ART club. The group meets either at a facility or community venue for less than an hour every 2 months. Group meetings are facilitated by a lay club facilitator who provides a quick clinical assessment, referral where necessary, and dispenses pre-packed ART. From January 2011 to December 2012, after adoption for phased rollout by the Western Cape Government, more than 600 ART clubs were established in Cape Town, providing ART care to over 16 000 patients. This extensive, rapid rollout demonstrates active buy-in from patients and facility staff. South Africa should consider a similar model for national rollout.

Long-term retention is greater following closed-book tests than open-book tests

2006 ◽  
Author(s):  
Pooja K. Agarwal ◽  
Jeffrey D. Karpicke ◽  
Sean H. Kang ◽  
Henry L. Roediger ◽  
Kathleen B. McDermott
Keyword(s):  
Open Book ◽  
Term Retention ◽  
Long Term Retention
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