Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya
OBJECTIVE: To determine the incidence of loss to follow-up in a treatment programme for people living with human immunodeficiency virus (HIV) infection in Kenya and to investigate how loss to follow-up is affected by gender. METHODS: Between November 2001 and November 2007, 50275 HIV-positive indivi...
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| Format: | Article |
| Language: | English |
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The World Health Organization
2010-09-01
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000900012&lng=en&tlng=en |
| _version_ | 1797288830605197312 |
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| author | Vincent Ochieng-Ooko Daniel Ochieng John E Sidle Margaret Holdsworth Kara Wools-Kaloustian Abraham M Siika Constantin T Yiannoutsos Michael Owiti Sylvester Kimaiyo Paula Braitstein |
| author_facet | Vincent Ochieng-Ooko Daniel Ochieng John E Sidle Margaret Holdsworth Kara Wools-Kaloustian Abraham M Siika Constantin T Yiannoutsos Michael Owiti Sylvester Kimaiyo Paula Braitstein |
| author_sort | Vincent Ochieng-Ooko |
| collection | DOAJ |
| description | OBJECTIVE: To determine the incidence of loss to follow-up in a treatment programme for people living with human immunodeficiency virus (HIV) infection in Kenya and to investigate how loss to follow-up is affected by gender. METHODS: Between November 2001 and November 2007, 50275 HIV-positive individuals aged > 14 years (69% female; median age: 36.2 years) were enrolled in the study. An individual was lost to follow-up when absent from the HIV treatment clinic for 3 months if on combination antiretroviral therapy (cART) or for 6 months if not. The incidence of loss to follow-up was calculated using Kaplan-Meier methods and factors associated with loss to follow-up were identified by logistic and Cox multivariate regression analysis. FINDINGS: Overall, 8% of individuals attended no follow-up visits, and 54% of them were lost to follow-up. The overall incidence of loss to follow-up was 25.1 per 100 person-years. Among the 92% who attended at least one follow-up visit, the incidence of loss to follow-up before and after starting cART was 27.2 and 14.0 per 100 person-years, respectively. Baseline factors associated with loss to follow-up included younger age, a long travel time to the clinic, patient disclosure of positive HIV status, high CD4+ lymphocyte count, advanced-stage HIV disease, and rural clinic location. Men were at an increased risk overall and before and after starting cART. CONCLUSION: The risk of being lost to follow-up was high, particularly before starting cART. Men were more likely to become lost to follow-up, even after adjusting for baseline sociodemographic and clinical characteristics. Interventions designed for men and women separately could improve retention. |
| first_indexed | 2024-03-07T18:55:09Z |
| format | Article |
| id | doaj.art-3c8e889b521e4322bfeb72b726be78e6 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:55:09Z |
| publishDate | 2010-09-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-3c8e889b521e4322bfeb72b726be78e62024-03-02T00:27:46ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862010-09-01889681688S0042-96862010000900012Influence of gender on loss to follow-up in a large HIV treatment programme in western KenyaVincent Ochieng-Ooko0Daniel Ochieng1John E Sidle2Margaret Holdsworth3Kara Wools-Kaloustian4Abraham M Siika5Constantin T Yiannoutsos6Michael Owiti7Sylvester Kimaiyo8Paula Braitstein9United States Agency for International DevelopmentUnited States Agency for International DevelopmentIndiana University School of MedicineUnited States Agency for International DevelopmentIndiana University School of MedicineIndiana University School of MedicineIndiana UniversityMoi UniversityMoi UniversityIndiana University School of MedicineOBJECTIVE: To determine the incidence of loss to follow-up in a treatment programme for people living with human immunodeficiency virus (HIV) infection in Kenya and to investigate how loss to follow-up is affected by gender. METHODS: Between November 2001 and November 2007, 50275 HIV-positive individuals aged > 14 years (69% female; median age: 36.2 years) were enrolled in the study. An individual was lost to follow-up when absent from the HIV treatment clinic for 3 months if on combination antiretroviral therapy (cART) or for 6 months if not. The incidence of loss to follow-up was calculated using Kaplan-Meier methods and factors associated with loss to follow-up were identified by logistic and Cox multivariate regression analysis. FINDINGS: Overall, 8% of individuals attended no follow-up visits, and 54% of them were lost to follow-up. The overall incidence of loss to follow-up was 25.1 per 100 person-years. Among the 92% who attended at least one follow-up visit, the incidence of loss to follow-up before and after starting cART was 27.2 and 14.0 per 100 person-years, respectively. Baseline factors associated with loss to follow-up included younger age, a long travel time to the clinic, patient disclosure of positive HIV status, high CD4+ lymphocyte count, advanced-stage HIV disease, and rural clinic location. Men were at an increased risk overall and before and after starting cART. CONCLUSION: The risk of being lost to follow-up was high, particularly before starting cART. Men were more likely to become lost to follow-up, even after adjusting for baseline sociodemographic and clinical characteristics. Interventions designed for men and women separately could improve retention.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000900012&lng=en&tlng=en |
| spellingShingle | Vincent Ochieng-Ooko Daniel Ochieng John E Sidle Margaret Holdsworth Kara Wools-Kaloustian Abraham M Siika Constantin T Yiannoutsos Michael Owiti Sylvester Kimaiyo Paula Braitstein Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya Bulletin of the World Health Organization |
| title | Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya |
| title_full | Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya |
| title_fullStr | Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya |
| title_full_unstemmed | Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya |
| title_short | Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya |
| title_sort | influence of gender on loss to follow up in a large hiv treatment programme in western kenya |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000900012&lng=en&tlng=en |
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