Retention of People Living with HIV and Factors Associated with Attrition at 36 Months: Case of Patients Followed at the Outpatient Treatment Center in Dakar Fann
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Abstract
Introduction: Retention has become a challenge for AIDS programs, especially in countries with limited resources.
However, for better care, it is essential that infected people stay in treatment programs for a long time. It is in this context that
we conducted this study which focused on the retention of PLHIV on ARVs at the Dakar CTA.
Methodology: This was a retrospective descriptive and analytical study on patients over 15 years of age living with HIV
naïve to antiretroviral treatment and whose file was opened between 2011 and 2016 at the Fann outpatient treatment center
with at least 36 months of follow-up under treatment.
Results: The study population was 432 patients with a predominance of women (57.2%), married (47.9%), informal
sector workers (67.8%), and patients from the Dakar region (94%). The median age was 36 years with a predominance of
patients aged 30 to 39 years. The majority of patients were classified as stage III and IV by WHO (52.3%). BMI between 18
and 25 affected 54.3% of patients. The majority of patients (94.2%) were infected with HIV-1 and the median LTCD4 baseline
was 235 cells/mm3. The 36-month retention rate (86%) of patients at CTA. The factors significantly associated with attrition
at 36 months were age, sex, BMI, clinical stage and CD4 count, but these factors differ depending on whether one is looking
at the lost to follow-up or death. The factors significantly associated with attrition at 36 months were age, sex, BMI, clinical
stage and CD4 count, but these factors differ depending on whether one is looking at the lost to follow-up or death, while sex
and region of residence were associated with the risk of being lost to follow-up. Only BMI was associated with both the risk
of death and loss of vision, with a stronger association with mortality.
Conclusion: The outcome of patients on treatment in patients followed by CTA was good. However, additional efforts
must be made to achieve 90% retention on treatment and contribute to the eradication of the virus by 2030.