| dc.description.abstract | Background: The human immunodeficiency virus (HIV) is a major health issue in South Africa. Treatment success requires that HIV infected people remain on treatment and are followed up regularly. Using a socioecological approach, this study investigated a wide range of factors that could be associated with being lost to follow-up (LTFU) in rural South Africa.
Methods: Data from the ITREMA randomised control trial (RCT) conducted at the Ndlovu clinic in Elandsdoorn, Limpopo, rural South Africa were used to assess which factors could be associated with LTFU. LTFU was defined as a participant who had not visited the clinic for more than 90 days after the last scheduled clinical visit date, and prior to end of study, without being transferred out or being documented as deceased. Through logistic regression, LTFU was analysed with the following potential covariates: sociodemographic, risk behaviour, depression, coping abilities, health literacy, physical health, adherence, social support, caregiver trust, stigma and quality of life.
Results: Out of 501 patients, 15.8% (n=79) were LTFU. Factors associated with LTFU included young age (odds ratio [OR]: 0.91, confidence interval [CI]: 0.86-0.96), depressive symptoms (OR: 11.32, CI: 2.44-61.58), low developed emotional orientated coping styles (OR: 0.84, CI: 0.73-0.95), high developed avoidance orientated coping styles (OR: 1.14, CI: 1.03-1.27), poor adherence (OR: 6.82, CI: 2.31-22.64) and a lower quality of life (OR:0.90, CI: 0.85-0.96).
Conclusion: Based on the results it is recommended that the South African government encourages healthcare providers to monitor the overall well-being of
HIV infected individuals by screening for depressive symptoms and poor adherence and provides additional support to develop coping styles of HIV positive people to prevent low retention rates and achieve long-term treatment success. However, further research is recommended as not enough data on factors associated with LTFU is available. | |
