Rate and predictors of loss to follow-up in HIV care in a low-resource setting: analyzing critical risk periods
Published in Biomedical Research
Why Do Some People Stop HIV Treatment? Understanding the Key Moments
In the global fight against HIV, keeping people engaged in their treatment is crucial. Even though many countries aim to meet ambitious HIV care goals by 2030, a significant challenge remains: helping those who start HIV treatment continue their care and keep their virus under control. A big part of this challenge is what’s known as "loss to follow-up" (LTFU).
What is Loss to Follow-Up (LTFU)?
LTFU happens when someone on HIV treatment misses their medical appointments or stops taking their medication for over 28 days. This is a serious issue, as it can lead to poorer health, increased risk of death, and a higher chance of spreading HIV to others because the virus isn’t being suppressed.
When Do People Stop Treatment?
This study looked at 737 adults who were new to HIV care and identified the times when they were most likely to stop their treatment:
- The First 6 Months Are Critical: About 50% of the people who dropped out of care did so within the first six months. This early period is a high-risk time, with an LTFU rate nine times higher than later periods (13-24 months). People might face challenges like dealing with side effects, struggling to adjust to a new routine, or not yet seeing the benefits of the medication.
- 7-12 Months: A Continued Risk: Even though the risk of dropping out decreases after the first six months, many people still struggle to stick with their treatment during months 7-12. About 30% of those who stopped care did so during this time. Factors like financial difficulties, stigma, or transportation issues can continue to affect them.
- After 12 Months: A More Stable Phase: After a year on treatment, the dropout rate drops significantly. By this time, many patients have adjusted to their routine, seen improvements in their health, and are more committed to their treatment.
What Can We Do About It?
The findings suggest that the first six months of HIV treatment are a make-or-break time. Health programs should focus on providing extra support during this period, such as helping patients manage side effects and offering counseling. Continued support is also important in the following months to help people overcome challenges that might come up later.
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BMC Infectious Diseases
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