Pilot study on assessment of LTFU of HIV-infected patients
To examine factors associated with
1. Non-retention in care prior to ART initiation
2. Late ART initiation in Rwanda in the context of recently expanded treatment guidelines. Rwanda expanded ART eligibility to 350 cells in 2008 and again in 2012 to 500 cells/ÂµL. Through one-time structured interviews at 4 HIV care clinics, Aim 1 will characterize potential determinants of:
Among a sample of patients initiating ART (n=400). Interviews will allow us to look at determinants beyond basic demographic and clinical factors in Rwanda, including those related to the timing of HIV diagnosis, testing circumstances, HIV knowledge and treatment literacy, perceived/enacted stigma, mental health, and care experiences. By linking baseline interview information with the existing longitudinal clinical database at each site, we will assess the determinants of non-retention prior to ART initiation, and, for those initiating ART, retention in care following ART initiation among other key outcomes. Since we will use existing protocols and instruments from an existing study of late ART initiation in the region (1R01MH089831, PIs Nash and Elul), substantial time and effort will be saved.
The HIV treatment program in Rwanda is anticipated to have a status Quo scenario that would have similar results in a >25% increase in demand for HIV treatment over a 5-year period (Figure 1). The analysis finds simultaneous improvements in engagement along the care continuum will result in ART coverage estimates that exceed WHO targets. In this preliminary work, the study team also evaluated the modelâ€™s performance.36-38 We compared model predictions to country-level reports of the number on ART over time.39-40 Model estimates of the number on ART closely approximate country reports of the number on treatment in Rwanda between 2004 and 2012 (Figure 2). We will carry out a pilot study under Kicukiro and Gahanga health Centers under Masaka district hospital.
Marcellin F, Abe C, Loubiere S, et al. Delayed first consultation after diagnosis of HIV infection in Cameroon. AIDS 2009;23:1015-9.