期刊
AIDS AND BEHAVIOR
卷 19, 期 4, 页码 666-678出版社
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10461-014-0874-0
关键词
HIV/AIDS; Southern Africa; Mozambique; Retention; Pre-ART loss to follow-up
资金
- President's Emergency Plan for AIDS Relief (PEPFAR) through the US Department of Health and Human Services, Centers for Disease Control and Prevention [U2GPS000631]
Within Mozambique's current HIV care system, there are numerous opportunities for a person to become lost to follow-up (LTFU) prior to initiating antiretroviral therapy (pre-ART). We explored pre-ART LTFU in Zamb,zia province utilizing quantitative and qualitative methods. Patients were deemed LTFU if they were more than 60 days late for either a scheduled appointment or a CD4+ cell count blood draw, according to national guidelines. Among 13,968 adult patients registered for care, 211 (1.8 %) died, one transferred, 2,196 (15.7 %) initiated ART, and 9,195 (65.8 %) were LTFU during the first year. Being male, younger, less educated, and/or having no home electricity were associated with LTFU. Qualitative interviews revealed that poor clinical care, logistics and competing priorities contribute to attrition. In addition, many expressed fears of stigma and/or rejection by family or community members because they were HIV-infected. At 66 %, pre-ART LTFU in Zamb,zia, Mozambique is a significant problem. This study highlights characteristics of lost patients and discusses barriers requiring consideration to improve retention.
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