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Socioeconomic support reduces nonretention in a comprehensive, community-based antiretroviral therapy program in Uganda.
- Source :
-
Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2012 Apr 01; Vol. 59 (4), pp. e52-9. - Publication Year :
- 2012
-
Abstract
- Objectives: We evaluated the benefit of socioeconomic support (S-E support), comprising various financial and nonfinancial services that are available based on assessment of need, in reducing mortality and lost to follow-up (LTFU) at Reach Out Mbuya, a community-based, antiretroviral therapy program in Uganda.<br />Design: Retrospective observational cohort data from adult patients enrolled between May 31, 2001, and May 31, 2010, were examined.<br />Methods: Patients were categorized into none, 1, and 2 or more S-E support based on the number of different S-E support services they received. Using Cox proportional hazards regression, we modeled the association between S-E support and mortality or LTFU. Kaplan-Meier curves were fitted to examine retention functions stratified by S-E support.<br />Results: In total, 6654 patients were evaluated. After 10 years, 2700 (41%) were retained. Of the 3954 not retained, 2933 (74%) were LTFU and 1021 (26%) had died. After 1, 2, 5, and 10 years, the risks of LTFU or mortality in patients who received no S-E support were significantly higher than those who received some S-E support. In adjusted hazards ratios, patients who received no S-E support were 1.5-fold (1.39-1.64) and 6.7-fold (5.56-7.69) more likely to get LTFU compared with those who received 1 or ≥ 2 S-E support, respectively. Likewise, patients who received no S-E support were 1.5-fold (confidence interval: 1.16 to 1.89) and 4.3-fold (confidence interval: 2.94 to 6.25) more likely to die compared with those who received 1 or 2+ S-E support, respectively.<br />Conclusions: Provision of S-E support reduced LTFU and mortality, suggesting the value of incorporating such strategies for promoting continuity of care.
- Subjects :
- Adolescent
Adult
Anti-HIV Agents therapeutic use
Female
HIV Infections mortality
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Uganda
Young Adult
Antiretroviral Therapy, Highly Active psychology
HIV Infections drug therapy
HIV Infections psychology
Lost to Follow-Up
Social Support
Subjects
Details
- Language :
- English
- ISSN :
- 1944-7884
- Volume :
- 59
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of acquired immune deficiency syndromes (1999)
- Publication Type :
- Academic Journal
- Accession number :
- 22217680
- Full Text :
- https://doi.org/10.1097/QAI.0b013e318246e2aa