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Pattern of linkage and retention in HIV care continuum among patients attending referral HIV care clinic in private sector in India

Bibliographic Data

ID19441250
AuthorsRitu Parchure (0000-0001-9865-2506, Praj (India), corresponding author), Vinay Kulkarni (0000-0003-1570-1339, Praj (India)), Sanjeevani Kulkarni (Praj (India)), Raman Gangakhedkar (0000-0002-9641-7366, National AIDS Research Institute)
Year2015
Volume27
Issue6
Pages716-722
Publication date2015-06-03
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2014.996518
PMID25559639
OpenAlexW2126492684
LanguageEN
Citations received3
References cited12

Continued engagement throughout the HIV care continuum, from HIV diagnosis through retention on antiretroviral therapy (ART), is crucial for enhancing impact of HIV care programs. We assessed linkage and retention in HIV care among people living with HIV (PLHIV) enrolled at a private HIV care clinic in Pune, India. Of 1220 patients, 28% delayed linkage after HIV diagnosis with a median delay of 24 months (IQR = 8-43). Younger people, women, low socioeconomic status, and those diagnosed at facilities other than the study clinic were more likely to delay linkage. Those with advanced HIV disease at diagnosis and testing for HIV due to HIV-related illness were linked to care immediately. Of a total of 629 patients eligible for ART at first CD4 count, 68% initiated ART within 3 months. Among those not eligible for ART, only 46% of patients sought subsequent CD4 count in time. Multivariate logistic regression analysis revealed that patients with initial CD4 count of 350-500 cells/cu mm (OR: 2, 95% CI: 1.1-3.5) and >500 cells/cu mm (OR: 2.1, 95% CI: 1.2-3.7) were less likely to do subsequent CD4 test on time as compared to those with CD4 12 years of education (OR: 0.4, 95% CI: 0.2-0.9) were more likely to have timely uptake of subsequent CD4 count. Among ART eligible patients, being an unskilled laborer (OR: 2.2, 95% CI: 1.1-4.2) predicted lower uptake. The study highlights a long delay from HIV diagnosis to linkage and further attrition during pre-ART and ART phases. It identifies need for newer approaches aimed at timely linkage and continued retention for patients with low education, unskilled laborers, and importantly, asymptomatic patients

Antiretroviral therapy · Environmental health · Family medicine · Health care · Logistic regression · Multivariate analysis · Population · Referral · Socioeconomic status · Viral load · HIV Research and Treatment · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Internal Medicine · Pediatrics

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Citations per year0.27
Citation span2015 - 2017 (3)
Highly citedNo
Open DOISci-Hub
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