Retention of antiretroviral naïve patients registered in HIV care in a program clinic in Pune, India

• Published in: Indian journal of sexually transmitted diseases and AIDS Vol. 35; no. 2; p. 124
• Main Authors: Ghate, Manisha, Zirpe, Sunil, Gurav, Nilam, Rewari, Bharat, Gangakhedkar, Raman, Paranjape, Ramesh
• Format: Journal Article
• Language: English
• Published: Mumbai Medknow Publications & Media Pvt. Ltd 01-07-2014
• ISSN: 2589-0557; 2589-0565
• DOI: 10.4103/0253-7184.142407

Background: Retention in HIV care ensures delivery of services like secondary prevention, timely initiation of treatment, support, and care on a regular basis. The data on retention in pre antiretroviral therapy (ART) care in India is scanty. Materials and Methods: Antiretroviral naove HIV-infected adult patients registered between January 2011 and March 2012 in HIV care (pre-ART) were included in the study. The follow-up procedures were done as per the national guidelines. Patients who did not report to the clinic for 1 year were considered as pre-ART lost to follow-up (pre-ART LFU). They were contacted either telephonically or by home visits. Logistic regression analysis was done to find out factors associated with pre-ART loss to follow-up. Results: A total of 689 antiretroviral naove adult patients were registered in the HIV care. Fourteen (2%) patients died and 76 (11%) were LFU till March 2013. The multivariate analysis showed that baseline CD4 count >350 cells/mm 3 (P < 0.01) and illiteracy (P = 0.044) were significantly associated with LFU. Of the total pre-ART LFUs, 35 (46.1%) informed that they would visit the clinic at their convenient time. NGOs that referred 16 female sex workers (FSWs) who were LFU (21.1%) informed that they would make efforts to refer them to the clinic. Conclusion: Higher CD4 count and illiteracy were significantly associated with lower retention in pre-ART care. Developing effective "retention package" for patients and strengthening linkage strategies between key sub-population such as FSWs and ART programming will help to plug the leaky cascade in HIV care.