Determinants of loss to follow-up among people living with HIV on antiretroviral therapy in Nigeria

Abstract

Background: Considerable success has been recorded in the global fight against the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Retention in care is the key to the attainment of set goals in the fight against the disease. We aim to determine the factors associated with loss to follow-up (LTFU) among people living with HIV on antiretroviral therapy (ART) in a limited resource setting.
Method: This was a retrospective cohort study that included adult patients who accessed ART at the study site between January 2005 and October 2018. A multivariate logistic regression model was used to obtain adjusted odds ratios and 95% confidence intervals of independent determinants of LTFU.
Results: Of the 8 679 patients included in the study, 3 716 (43%) were males, 4 009 (46%) were enrolled during the years 2005 to 2008, 8 421 (97%) spent less than two hours travelling from their residence to the treatment centre, and 3 523 (41%) had their first-line ART regimen changed. Among the characteristics that determine LTFU were male patients (OR = 1.167, 95% CI: 1.071–1.272), and World Health Organization clinical stage 3 (OR = 2.091, 95% CI: 1.485–2.944).
Conclusion: In our study, male gender, enrolment year 2005 to 2008, no change in first-line ART and nevirapinebased therapy were more likely to be associated with LTFU.

Keywords: adherence, adult, cohort studies, retention in care