Routine HIV clinic visit adherence in the African Cohort Study

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dc.contributor.authorDear, Nicole
dc.contributor.authorEsber, Allahna
dc.contributor.authorIroezindu, Michael
dc.contributor.authorBahemana, Emmanuel
dc.contributor.authorKibuuka, Hannah
dc.contributor.authorMaswai, Jonah
dc.contributor.authorOwuoth, John
dc.contributor.authorPolyak, Christina S.
dc.contributor.authorAke, Julie A.
dc.contributor.authorCrowell, Trevor A.
dc.date.accessioned2022-12-15T18:11:59Z
dc.date.available2022-12-15T18:11:59Z
dc.date.issued2022
dc.description.abstractRetention in clinical care is important for people living with HIV (PLWH). Evidence suggests that missed clinic visits are associated with interruptions in antiretroviral therapy (ART), lower CD4 counts, virologic failure, and overlooked coinfections. We identified factors associated with missed routine clinic visits in the African Cohort Study (AFRICOS). Methods: In 2013, AFRICOS began enrolling people with and without HIV in Uganda, Kenya, Tanzania, and Nigeria. At enrollment and every 6 months thereafter, sociodemographic questionnaires are administered and clinical outcomes assessed. Missed clinic visits were measured as the self-reported number of clinic visits missed in the past 6 months and dichotomized into none or one or more visits missed. Logistic regression with generalized estimating equations was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between risk factors and missed visits. Results: Between January 2013 and March 2020, 2937 PLWH were enrolled, of whom 2807 (95.6%) had initiated ART and 2771 had complete data available for analyses. Compared to PLWH 50+, missed clinic visits were more common among those 18–29 years (aOR 2.33, 95% CI 1.65–3.29), 30–39 years (aOR 1.59, 95% CI 1.19–2.13), and 40–49 years (aOR 1.42, 95% CI 1.07–1.89). As compared to PLWH on ART for < 2 years, those on ART for 4+ years were less likely to have missed clinic visits (aOR 0.72, 95% CI 0.55–0.95). Missed clinic visits were associated with alcohol use (aOR 1.34, 95% CI 1.05–1.70), a history of incarceration (aOR 1.42, 95% CI 1.07–1.88), depression (aOR 1.47, 95% CI 1.13–1.91), and viral non-suppression (aOR 2.50, 95% CI 2.00–3.12). As compared to PLWH who did not miss any ART in the past month, missed clinic visits were more common among those who missed 1–2 days (aOR 2.09, 95% CI 1.65–2.64) and 3+ days of ART (aOR 7.06, 95% CI 5.43–9.19). Conclusions: Inconsistent clinic attendance is associated with worsened HIV-related outcomes. Strategies to improve visit adherence are especially needed for young PLWH and those with depression.en_US
dc.identifier.citationDear, N., Esber, A., Iroezindu, M., Bahemana, E., Kibuuka, H., Maswai, J., ... & Crowell, T. A. (2022). Routine HIV clinic visit adherence in the African Cohort Study. AIDS research and therapy, 19(1), 1-12. https://doi.org/10.1186/s12981-021-00425-0en_US
dc.identifier.urihttps://doi.org/10.1186/s12981-021-00425-0
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6337
dc.language.isoenen_US
dc.publisherAIDS research and therapyen_US
dc.subjectHIVen_US
dc.subjectEast Africaen_US
dc.subjectClinic visitsen_US
dc.subjectPatient engagementen_US
dc.subjectCare retentionen_US
dc.titleRoutine HIV clinic visit adherence in the African Cohort Studyen_US
dc.typeArticleen_US
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