2023-09-28 14:46:10 +00:00
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abstract: 'Despite progress on population-level HIV viral suppression, unknown
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outcomes amongst people who have initiated antiretroviral therapy (ART)
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in low- and middle-income countries, commonly referred to as loss to
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follow-up (LTFU), remains a barrier. The mean global estimate of LTFU is
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20\%, exceeding the World Health Organization target of <15\%. Pervasive
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predictors associated with LTFU include younger age, low body mass
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index, low CD4 count, advanced HIV clinical stage and certain ART
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regimens. In Namibia, ART use by eligible individuals exceeds 85\%,
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surpassing the global average. Nonetheless, LTFU remains a barrier to
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achieving viral suppression and requires research to elucidate
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context-specific factors. An observational cohort study was conducted in
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Namibia in 2012 by administering surveys to individuals who presented
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for HIV care and initiated ART for the first time. Additional data were
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collected from routine medical data monitoring systems. Participants
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classified as LTFU at 12 months were traced to confirm their status.
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Predictors of LTFU were analyzed using multivariable logistic
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regression. Of those who presented consecutively to initiate ART, 524
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were identified as eligible to enroll in the study, 497 enrolled, and
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474 completed the baseline questionnaire. The cohort had mean age 36
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years, 39\% were male, mean CD4 cell count 222 cells/mm3, 17\% were WHO
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HIV clinical stage and 14\% started efavirenz-based regimens. Tracing
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participants classified as LTFU yielded a re-categorization from 27.8\%
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(n = 132) to 14.3\% (n = 68) LTFU. In the final multivariable model,
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factors associated with confirmed LTFU status were: younger age (OR
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0.97, 95\% CI 1.00-1.06, p = 0.02); male sex (OR 2.34, CI 1.34-4.06, p =
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0.003); difficulty leaving work or home to attend clinic (OR 2.55, CI
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1.40-4.65, p = 0.002); and baseline efavirenz-based regimen (OR 2.35, CI
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1.22-4.51, p = 0.01). Interventions to reduce LTFU should therefore
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target young men, particularly those who report difficulty leaving work
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or home to attend clinic and are on an efavirenz-based regimen.'
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affiliation: 'Hong, SY (Corresponding Author), Tufts Med Ctr, Div Geog Med \& Infect
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Dis, Boston, MA 02111 USA.
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Hong, SY (Corresponding Author), Tufts Univ, Sch Med, Dept Publ Hlth \& Community
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Med, Boston, MA 02111 USA.
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Hong, Steven Y.; Wanke, Christine; Jordan, Michael R., Tufts Med Ctr, Div Geog Med
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\& Infect Dis, Boston, MA 02111 USA.
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Hong, Steven Y.; Roy, Tuhin; Wanke, Christine; Tang, Alice M.; Jordan, Michael R.,
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Tufts Univ, Sch Med, Dept Publ Hlth \& Community Med, Boston, MA 02111 USA.
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Winston, Anna, Hosp Univ Penn, 3400 Spruce St, Philadelphia, PA 19104 USA.
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Mutenda, Nicholus; Hamunime, Ndapewa, Republ Namibia Minist Hlth \& Social Serv,
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Directorate Special Programmes, Windhoek, Namibia.'
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article-number: e0266438
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author: Hong, Steven Y. and Winston, Anna and Mutenda, Nicholus and Hamunime, Ndapewa
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and Roy, Tuhin and Wanke, Christine and Tang, Alice M. and Jordan, Michael R.
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author-email: shong@tuftsmedicalcenter.org
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author_list:
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- family: Hong
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given: Steven Y.
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- family: Winston
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given: Anna
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- family: Mutenda
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given: Nicholus
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- family: Hamunime
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given: Ndapewa
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- family: Roy
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given: Tuhin
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- family: Wanke
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given: Christine
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- family: Tang
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given: Alice M.
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- family: Jordan
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given: Michael R.
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da: '2023-09-28'
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doi: 10.1371/journal.pone.0266438
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files: []
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issn: 1932-6203
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journal: PLOS ONE
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keywords-plus: 'SUB-SAHARAN AFRICA; INFECTED PATIENTS; DRUG-RESISTANCE; ADULT PATIENTS;
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SCALING-UP; OUTCOMES; INITIATION; EXPERIENCE; RETENTION; EFAVIRENZ'
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language: English
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number: '4'
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number-of-cited-references: '40'
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orcid-numbers: Hong, Steven/0000-0002-2149-5132
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papis_id: edcb4c5e0fd33c5d4f52daa7a8851cfe
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ref: Hong2022predictorsloss
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times-cited: '1'
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title: Predictors of loss to follow-up from HIV antiretroviral therapy in Namibia
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000795453600047
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '17'
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web-of-science-categories: Multidisciplinary Sciences
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year: '2022'
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