2025/03/10 by S. Akakpo, Julienne Noudé Teclessou, AKAKPO, Abla Sefako +13
Medicine · Social Sciences · #African Studies and Ethnography #Afrique subsaharienne #Antiretrovirals #Antirétroviraux #HIV-related health complications and treatments #HIV/AIDS Research and Interventions #Health care #Lost to follow-up #PLWH #PVVIH #Perdus de vue #Retention in care #Rétention dans les soins #Soins de santé #Sub-Saharan Africa #Togo
paper · doi:10.48327/mtsi.v5i1.2025.664
openalex publication_date 2025/03/10 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
Introduction: The aim of our study was to analyze retention in care and survival at 12, 24, and 36 months among people living with HIV (PLWH) on antiretroviral therapy (ART). Methods: This is a retrospective cross-sectional analysis of a cohort of PLWH aged 15 years and older who started ART. Purposive sampling was used, taking into account the activities of different health centers and budgetary constraints (quantitative approach). In-depth individual interviews and focus groups were also conducted (qualitative approach). Results: 46 years). The median duration of ART was 5 years (IQR [2-8]) with no statistical difference by gender (p=0.752). At baseline, 20.5% (n=431) and 25.1% (n=509) were lost to follow-up (LTF) 90 days and 28 days after scheduled visit, respectively. There were 146 adult deaths, for a crude mortality rate of 6.9% (95% CI [5.9-8.1]). Approximately 60% of the 158 PLWH randomly selected from our LTF patients could be reached by telephone. They reported that they were still in care. Retention in care was 72.5%, and the probability of retention was 91.6% at 12 months, 87.8% at 24 months, and 78.7% at 60 months. Retention in care was more pronounced among women and more significant among PLWH aged 35 years and older when treatment was initiated in health care facilities offering the full range of activities (care and treatment, active patient search, presence of social mediators). Conclusion: Our study, conducted during the Covid-19 pandemic, shows acceptable retention rates in care for PLWH. These results make possible to propose solutions to improve the care program in the country: the harmonization of procedures for tracing PLWH with the implementation of their active search (with the help of community mediators) and the dispensing of ART to PLWH for three or six months.