Cascade of Care for HIV Positive Patients in a Rural Health Region in the North-Central Region of Ivory Coast: A Follow-up Study.

Objective: To describe the cascade of care for HIV positive patients in the health region of Worodougou-Béré, North-Central Region of Ivory Coast. Methods: Cross-sectional study which included patients diagnosed HIV positive between January 2009 and December 2012 was conducted. The analysis focused on different steps of care, from HIV screening to antiretroviral treatment (ART) initiation. Results: A total of 1659 people were diagnosed HIV positive and 992 (60%) of them were included in HIV care. Their median age and CD4 count were 33 years [27-41 years] and 311 cells/mm3 [162-548/mm3], respectively. Overall, 55% of them were female and 62% were symptomatic. The proportion of eligible patients was 52%, and 81% of them started ART. Conclusion: The cascade of HIV care in Worodougou-Béré Region had high attrition rate. A change in strategy, included point of care CD4 and viral load, is needed to increase access to ART and retention in care in these rural areas. [ABSTRACT FROM AUTHOR]