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Increasing Transfers-Out from an Antiretroviral Treatment Service in South Africa: Patient Characteristics and Rates of Virological Non-Suppression

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  • Mweete D Nglazi
  • Richard Kaplan
  • Catherine Orrell
  • Landon Myer
  • Robin Wood
  • Linda-Gail Bekker
  • Stephen D Lawn

Abstract

Objectives: To determine the proportion, characteristics and outcomes of patients who transfer-out from an antiretroviral therapy (ART) service in a South African township. Methods: This retrospective cohort study included all patients aged ≥15 years who enrolled between September 2002 and December 2009. Follow-up data were censored in December 2010. Kaplan-Meier survival analysis was used to describe time to transfer-out and cox proportional hazard analysis was used to determine associated risk factors. Results: 4511 patients (4003 ART-naïve and 508 non-naïve at baseline) received ART during the study period. Overall, 597 (13.2%) transferred out. The probability of transferring out by one year of ART steadily increased from 1.4% in 2002/2004 cohort to 8.9% for the 2009 cohort. Independent risk factors for transfer-out were more recent calendar year of enrolment, younger age (≤25 years) and being ART non-naïve at baseline (i.e., having previously transferred into this clinic from another facility). The proportions of patients transferred out who had a CD4 cell count 1000 copies/mL around the time of transfer, suggesting the need for careful adherence counseling and assessment of medication supplies among those planning transfer.

Suggested Citation

  • Mweete D Nglazi & Richard Kaplan & Catherine Orrell & Landon Myer & Robin Wood & Linda-Gail Bekker & Stephen D Lawn, 2013. "Increasing Transfers-Out from an Antiretroviral Treatment Service in South Africa: Patient Characteristics and Rates of Virological Non-Suppression," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-9, March.
    • Handle: RePEc:plo:pone00:0057907
    DOI: 10.1371/journal.pone.0057907
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    References listed on IDEAS

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    1. Sydney Rosen & Matthew P Fox & Christopher J Gill, 2007. "Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review," PLOS Medicine, Public Library of Science, vol. 4(10), pages 1-11, October.
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