Tracing-corrected estimates of disengagement from HIV care and mortality among patients enrolling in HIV care without overt immunosuppression in Tanzania

Bibliographic Data

ID19438689
AuthorsOlga Tymejczyk (0000-0002-8417-0650, Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA), Quynh Vo (0000-0003-1462-6525, ICAP, Columbia University, New York, NY, USA), Sarah Gorrell Kulkarni (Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA), Sarah Kulkarni (0000-0002-0807-339X, City University of New York), Gretchen Antelman (0000-0001-7906-9964, ICAP, Dar es Salaam, Tanzania), Judith Boshe (0000-0002-1684-7295, ICAP, Dar es Salaam, Tanzania), William Reidy (0000-0001-5701-038X, ICAP, Columbia University, New York, NY, USA), Angela Parcesepe (University of North Carolina at Chapel Hill), Angela M Parcesepe (0000-0002-4321-125X, University of North Carolina at Chapel Hill), Denis Nash (0000-0002-3280-5386, Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA), Batya Elul (0000-0001-6101-3073, ICAP, Columbia University, New York, NY, USA, corresponding author)
Year2021
Volume33
Issue1
Pages47-53
Publication date2021-01-02
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2019.1699642
PMID31826640
OpenAlexW2994920779
LanguageEN
Citations received2
References cited18

In the era of "test and treat", it is important to understand HIV care outcomes and their determinants in patients presenting to care with early-stage disease. We surveyed 924 adults newly enrolling in HIV care at four clinics in Tanzania before the adoption of universal treatment eligibility, and collected longitudinal clinical data. Participants who defaulted from care were tracked in the community. Cumulative incidence of disengagement from care and death was estimated using competing risk methods. By 12 months after enrollment, 18.2% of patients had disengaged from care and 6.9% had died. Factors associated with disengagement included male sex (adjusted subhazard ratio [aSHR] versus female = 1.75, 95% confidence interval [CI]: 1.06-2.89), provider-initiated HIV diagnosis (aSHR versus self-referred = 1.71, 95% CI: 1.03-2.86), ineligibility for antiretroviral treatment (ART) at enrollment (aSHR versus eligibility = 2.82, 95% CI: 1.84-4.32) and increased anticipated stigma score (aSHR = 1.04 per 5-point increase, 95% CI: 1.02-1.05). Higher life satisfaction score (aSHR = 0.97 per 5-point increase, 95% CI: 0.95-0.99) and having 1-2 close friends (aSHR versus none = 0.58, 95% CI: 0.47-0.71) were protective. The findings highlight the continued importance of social environment for HIV care outcomes and the potential of universal ART eligibility to reduce HIV care attrition

Confidence interval · Disengagement theory · Family medicine · Tanzania · Demography · HIV Research and Treatment · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Gerontology · Internal Medicine · Pediatrics

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