Decentralizing ART supply for stable HIV patients to community-based distribution centers: program outcomes from an urban context in Kinshasa, DRC

Florian Vogt, Lucien Kalenga, Jean Lukela, Freddy Salumu, Ibrahim Diallo, Elena Nico, Emmanuel Lampart, Rafael Van den Bergh, Safieh Shah, Olumide Ogundahunsi, Rony Zachariah, Johan Van Griensven

Research output: Contribution to journalA1: Web of Science-article

Abstract

Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centers among 2603 patients with HIV in Kinshasa, Democratic Republic of Congo, using a multilevel Poisson regression model. Death, loss to followup, and transfer out were 0.3%, 9.0%, and 0.7%, respectively, at 24 months. Overall attrition was 5.66/100 person-years. Patients with > 3 years on ART,> 500 cluster of differentiation type-4 count, body mass index > 18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centers are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage.

Original languageEnglish
JournalJournal of Acquired Immune Deficiency Syndromes
Volume74
Issue number3
Pages (from-to)326-331
Number of pages6
ISSN1525-4135
DOIs
Publication statusPublished - 2017

Keywords

  • antiretroviral therapy
  • HIV
  • decentralization
  • task shifting
  • community
  • urban
  • SUB-SAHARAN AFRICA
  • ANTIRETROVIRAL TREATMENT OUTCOMES
  • MIDDLE-INCOME COUNTRIES
  • HIV/AIDS TREATMENT
  • PROSPECTIVE COHORT
  • CLINICAL-OUTCOMES
  • CARE PROGRAM
  • RURAL UGANDA
  • AIDS CARE
  • SCALE-UP

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