AUTHOR=Leno Niouma Nestor , Guilavogui Foromo , Camara Alioune , Kadio Kadio Jean-Jacques Olivier , Guilavogui Timothé , Diallo Thierno Saidou , Diallo Mamadou Aliou , Leno Daniel William Athanase , Ricarte Button , Koita Youssouf , Kaba Laye , Ahiatsi Arnold , Touré Nagnouman , Traoré Pascal , Chaloub Souleymane , Kamano André , Vicente Carlos Arias , Delamou Alexandre , Cissé Mohamed 

TITLE=Retention and Predictors of Attrition Among People Living With HIV on Antiretroviral Therapy in Guinea: A 13-Year Historical Cohort Study in Nine Large-Volume Sites

JOURNAL=International Journal of Public Health

VOLUME=68

YEAR=2023

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2023.1605929

DOI=10.3389/ijph.2023.1605929

ISSN=1661-8564

ABSTRACT=<p><bold>Objectives:</bold> The objective of this study was to estimate the retention rate of patients in an ART program and identify the predictors of attrition.</p><p><bold>Methods:</bold> This was a historical cohort study of HIV patients who started ART between September 2007 and April 2020, and were followed up on for at least 6 months in nine large-volume sites. Kaplan Meier techniques were used to estimate cumulative retention and attrition probabilities. Cox proportional hazards models were used to identify predictors of attrition.</p><p><bold>Results:</bold> The cumulative probability of retention at 12 and 24 months was 76.2% and 70.2%, respectively. The attrition rate after a median follow-up time of 3.1 years was 35.2%, or an incidence of 11.4 per 100 person-years. Having initiated ART between 2012 and 2015; unmarried status; having initiated ART with CD4 count &lt;100 cells/μL; and having initiated ART at an advanced clinical stage were factors significantly associated with attrition.</p><p><bold>Conclusion:</bold> The retention rate in our study is much lower than the proposed national target (90%). Studies to understand the reasons for loss to follow-up are needed.</p>