Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. The authors 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 follow-up, 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.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Vogt F, Kalenga L, Lukela J, Salumu F, Diallo I, Nico E, Lampart E, Van den Bergh R, Shah S, Ogundahunsi O, Zachariah R, Van Griensven J. Decentralizing ART supply for stable HIV patients to community-based distribution centres: Programme outcomes from an urban context in Kinshasa, DRC. Journal of acquired immune deficiency syndromes. 2016; 74(3):1.
Decentralizing ART supply for stable HIV patients to community-based distribution centres: Programme outcomes from an urban context in Kinshasa, DRC