2026-04-13T05:05:55Zhttps://recercat.cat/oai/requestoai:recercat.cat:2445/1829652025-12-05T00:30:32Zcom_2072_1057col_2072_478917
urn:hdl:2445/182965
Loss to follow-up and opportunities for reengagement in HIV care in rural Mozambique: A prospective cohort study.
Fuente Soro, Laura
López Varela, Elisa
Augusto, Orvalho
Bernardo, Edson Luis
Sacoor, Charfudin
Nhacolo, Ariel Q.
Ruiz Castillo, Paula
Alfredo, Charity
Karajeanes, Esmeralda
Vaz, Paula
Naniche, Denise
VIH (Virus)
Moçambic
HIV (Viruses)
Mozambique
"Patients lost to follow-up (LTFU) over the human
immunodeficiency virus (HIV) cascade have poor clinical outcomes
and contribute to onward HIV transmission. We assessed true care
outcomes and factors associated with successful reengagement in
patients LTFU in southern Mozambique.Newly diagnosed
HIV-positive adults were consecutively recruited in the
Manhi\xC3\xA7a District. Patients LTFU within 12 months after
HIV diagnosis were visited at home from June 2015 to July 2016
and interviewed for ascertainment of outcomes and reasons for
LTFU. Factors associated with reengagement in care within 90
days after the home visit were analyzed by Cox proportional
hazards model.Among 1122 newly HIV-diagnosed adults, 691 (61.6%)
were identified as LTFU. Of those, 557 (80.6%) were approached
at their homes and 321 (57.6%) found at home. Over 50% had died
or migrated, 10% had been misclassified as LTFU, and 252 (78.5%)
were interviewed. Following the visit, 79 (31.3%) reengaged in
care. Having registered in care and a shorter time between LTFU
and visit were associated with reengagement in multivariate
analyses: adjusted hazards ratio of 3.54 [95% confidence
interval (CI): 1.81-6.92; P\xE2\x80\x8A<\xE2\x80\x8A.001] and
0.93 (95% CI: 0.87-1.00; P\xE2\x80\x8A=\xE2\x80\x8A.045),
respectively. The most frequently reported barriers were the
lack of trust in the HIV-diagnosis, the perception of being in
good health, and fear of being badly treated by health personnel
and differed by type of LTFU.Estimates of LTFU in rural areas of
sub-Saharan Africa are likely to be overestimated in the absence
of active tracing strategies. Home visits are resource-intensive
but useful strategies for reengagement for at least one-third of
LTFU patients when applied in the context of differentiated care
for those LTFU individuals who had already enrolled in HIV care
at some point."
2022-02-07T08:37:08Z
2022-02-07T08:37:08Z
2020
2022-02-04T19:00:51Z
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Reproducció del document publicat a: http://dx.doi.org/ 10.1097/MD.0000000000020236
Medicine, 2020 , vol 99, num 20
http://dx.doi.org/ 10.1097/MD.0000000000020236
cc by-nc (c) Fuente Soro, Laura et al, 2020
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
Lippincott, Williams & Wilkins
Articles publicats en revistes (ISGlobal)