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Risk Factors for Loss to Follow-Up among People Who Inject Drugs in a Risk Reduction Program at Karachi, Pakistan. A Case-Cohort Study

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  • Rab Nawaz Samo
  • Ajmal Agha
  • Sharaf Ali Shah
  • Arshad Altaf
  • Ashraf Memon
  • Meridith Blevins
  • Han-Zhu Qian
  • Sten H Vermund

Abstract

Introduction: Retention of male people who inject drugs (PWIDs) is a major challenge for harm reduction programs that include sterile needle/syringe exchange in resource-limited settings like Pakistan. We assessed the risk factors for loss to follow-up among male PWIDs enrolled in a risk reduction program in Karachi, Pakistan. Methods: We conducted a prospective cohort study among 636 HIV-uninfected male PWIDs enrolled during March-June 2009 in a harm reduction program for the estimation of incidence rate. At 24 months post-enrollment, clients who had dropped out of the program were defined as lost to follow-up and included as cases for case-cohort study. Results: The median age of the participants was 29 years (interquartile range: 23–36). Active outreach accounted for 76% (483/636) of cohort recruits. Loss to follow-up at 24 months was 25.5% (162/636). In multivariable logistic regression, younger age (AOR: 0.97, 95% CI: 0.92–0.99, p = 0.028), clients from other provinces than Sindh (AOR: 1.49, 95% CI: 1.01–2.22, p = 0.046), having no formal education (AOR: 3.44, 95% CI: 2.35–4.90, p

Suggested Citation

  • Rab Nawaz Samo & Ajmal Agha & Sharaf Ali Shah & Arshad Altaf & Ashraf Memon & Meridith Blevins & Han-Zhu Qian & Sten H Vermund, 2016. "Risk Factors for Loss to Follow-Up among People Who Inject Drugs in a Risk Reduction Program at Karachi, Pakistan. A Case-Cohort Study," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-11, February.
    • Handle: RePEc:plo:pone00:0147912
    DOI: 10.1371/journal.pone.0147912
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