Point of Diagnosis and Patient Retention in HIV Care in Western Kenya

Genberg, Becky L.; Lee, Hana; Hogan, Joseph W.; Some, Fatma; Wachira, Juddy; Wu, Xiaotian K.; Braitstein, Paula

doi:10.1097/qai.0000000000001703

Cited by 5 publications

(1 citation statement)

References 24 publications

(29 reference statements)

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“…We defined retention in care based on established AMPATH care protocols where expected return to clinic dates are 3 months for patients on ART and 6 months for patients not on ART. This definition also aligns with similar research assessing retention in care among AMPATH patients living with HIV [21,22]. For patients retained in care, death during the follow-up period was determined from the AMPATH community tracking form and medical record data.…”

Section: Methodsmentioning

confidence: 92%

Microfinance, retention in care, and mortality among patients enrolled in HIV care in East Africa

Genberg

Wilson-Barthes

Omodi

et al. 2021

Aids

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Objective: To measure associations between participation in community-based microfinance groups, retention in HIV care, and death among people with HIV (PWH) in lowresource settings.Design and methods: We prospectively analyzed data from 3609 patients enrolled in an HIV care program in western Kenya. HIV patients who were eligible and chose to participate in a Group Integrated Savings for Health Empowerment (GISHE) microfinance group were matched 1 : 2 on age, sex, year of enrollment in HIV care, and location of initial HIV clinic visit to patients not participating in GISHE. Follow-up data were abstracted from medical records from January 2018 through February 2020. Logistic regression analysis examined associations between GISHE participation and two outcomes: retention in HIV care (i.e. >1 HIV care visit attended within 6 months prior to the end of follow-up) and death. Socioeconomic factors associated with HIV outcomes were included in adjusted models. Results:The study population was majority women (78.3%) with a median age of 37.4 years. Microfinance group participants were more likely to be retained in care relative to HIV patients not participating in a microfinance group [adjusted odds ratio (aOR) ¼ 1.31, 95% confidence interval (CI) 1.01-1.71; P ¼ 0.046]. Participation in group microfinance was associated with a reduced odds of death during the follow-up period (aOR ¼ 0.57, 95% CI 0.28-1.09; P ¼ 0.105). Conclusion:Participation in group-based microfinance appears to be associated with better HIV treatment outcomes. A randomized trial is needed to assess whether microfinance groups can improve clinical and socioeconomic outcomes among PWH in similar settings.

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Section: Methodsmentioning

confidence: 92%

Microfinance, retention in care, and mortality among patients enrolled in HIV care in East Africa

Genberg

Wilson-Barthes

Omodi

et al. 2021

Aids

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Factors Associated with Loss to Follow-Up Among Patients Receiving HIV Treatment in Nairobi, Kenya

Koech

Stafford

Mutysia

et al. 2021

AIDS Research and Human Retroviruses

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High Coverage of Antiretroviral Treatment With Annual Home-Based HIV Testing, Follow-up Linkage Services, and Implementation of Test and Start: Findings From the Chókwè Health Demographic Surveillance System, Mozambique, 2014–2019

Pathmanathan

Nelson

Louvado³

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Early antiretroviral therapy (ART) is necessary for HIV epidemic control and depends on early diagnosis and successful linkage to care. Since 2014, annual household-based HIV testing and counseling and linkage services have been provided through the Chókwè Health and Demographic Surveillance System for residents testing HIV positive in this high HIV-burden district. Methods: District-wide Test and Start [T&S, ART for all people living with HIV (PLHIV)] began in August 2016, supported by systematic interventions to improve linkage to care and treatment. Annual rounds (R) of random household surveys were conducted to assess trends in population prevalence of ART use and viral load suppression (<1000 viral RNA copies/mL). Results: Between R1 (April 2014–April 2015) and R5 (April 2018–Mar 2019), 46,090 (67.2%) of 68,620 residents aged 15–59 years were tested for HIV at home at least once, and 3711 were newly diagnosed with HIV and provided linkage services. Population prevalence of current ART use among PLHIV increased from 65.0% to 87.5% between R1 and R5. ART population prevalence was lowest among men aged 25–34 years (67.8%) and women aged 15–24 (78.0%), and highest among women aged 35–44 years (93.6%) and 45–59 years (93.7%) in R5. Viral load suppression prevalence increased among all PLHIV aged 15–59 years from 52.0% in R1 to 78.3% in R5. Discussion: Between 2014 and 2019, Chókwè Health and Demographic Surveillance System residents surpassed the UNAIDS targets of ≥81% of PLHIV on ART and ≥73% virally suppressed. This achievement supports the combination of efforts from household-based HIV testing and counseling, support for linkage to care and treatment, and continued investments in T&S implementation.

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Point of Diagnosis and Patient Retention in HIV Care in Western Kenya

Cited by 5 publications

References 24 publications

Microfinance, retention in care, and mortality among patients enrolled in HIV care in East Africa

Microfinance, retention in care, and mortality among patients enrolled in HIV care in East Africa

Factors Associated with Loss to Follow-Up Among Patients Receiving HIV Treatment in Nairobi, Kenya

High Coverage of Antiretroviral Treatment With Annual Home-Based HIV Testing, Follow-up Linkage Services, and Implementation of Test and Start: Findings From the Chókwè Health Demographic Surveillance System, Mozambique, 2014–2019

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