High Levels of Retention in Care with Streamlined Care and Universal Test-and-Treat in East Africa

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dc.contributor.authorBrown, Lillian B.
dc.contributor.authorHavlir, Diane V.
dc.contributor.authorAyieko, James
dc.contributor.authorMwangwa, Florence
dc.contributor.authorOwaraganise, Asiphas
dc.contributor.authorKwarisiima, Dalsone
dc.contributor.authorTamara, Clark
dc.contributor.authorBukusi, Elizabeth A.
dc.contributor.authorKamya, Moses R.
dc.contributor.authorPetersen, Maya L.
dc.contributor.authorCharlebois, Edwin D.
dc.contributor.authorThe Search Collaboration
dc.date.accessioned2022-08-24T20:33:24Z
dc.date.available2022-08-24T20:33:24Z
dc.date.issued2016
dc.description.abstractWe sought to measure retention in care and identify predictors of non-retention among patients receiving ART with streamlined delivery during the first year of the ongoing SEARCH “test-and-treat” trial (NCT 01864603) in rural Uganda and Kenya. Prospective cohort of patients in the intervention arm of the SEARCH Study. We measured retention in care at 12 months among HIV-infected adults who linked to care and were offered ART regardless of CD4 cell count, following community-wide HIV-testing. Kaplan-Meier estimates and Cox proportional hazards modeling were used to calculate the probability of retention at one year and identify predictors of non-retention. Among 5,683 adults (age ≥ 15) who linked to care, 95.5% (95% CI: 92.9 – 98.1%) were retained in care at 12 months. The overall probability of retention at one year was 89.3% (95% CI: 87.6 – 90.7%) among patients newly linking to care and 96.4% (95% CI: 95.8 – 97.0%) among patients previously in care. Younger age and pre-ART CD4 below country treatment initiation guidelines were predictors of non-retention among all patients. Among those newly linking, taking more than 30 days to link to care after HIV diagnosis was additionally associated with non-retention at one year. HIV viral load suppression at 12 months was observed in 4,227/4736 (89%) of patients retained with valid viral load results. High retention in care and viral suppression after 1 year were achieved in a streamlined HIV care delivery system in the context of a universal test-and-treat intervention.en_US
dc.identifier.citationBrown, L. B., Havlir, D. V., Ayieko, J., Mwangwa, F., Owaraganise, A., Kwarisiima, D., ... & SEARCH Collaboration. (2016). High levels of retention in care with streamlined care and universal test-and-treat in East Africa. AIDS (London, England), 30(18), 2855.https://doi.org/10.1097%2FQAD.0000000000001250en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/4413
dc.language.isoenen_US
dc.publisherAIDSen_US
dc.subjectHIV, Africa, Antiretroviral therapy, Healthcare, Retention in careen_US
dc.titleHigh Levels of Retention in Care with Streamlined Care and Universal Test-and-Treat in East Africaen_US
dc.typeArticleen_US
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