More than one-third of patients receiving HIV medication in Africa die or discontinue their treatment within two years, according to a study published in PLoS Medicine.
Boston University researcher Sydney Rosen and colleagues identified and analyzed scientific reports over the past 7 years that gave details on adult patients remaining on antiviral treatment in 13 sub-Saharan African countries. They found that 77.5% of patients remained on treatment after an average period of 9.9 months. Of the patients no longer on treatment, just under half had died and half had lost contact with the clinics for undetermined reasons. The average retention rate at two years was estimated at 61.6%, but individual programs ranged widely, between 46% and 85%.
The researchers noted that one way to improve retention might be to start treating people with HIV earlier, before they become seriously ill. Better efforts to find out exactly why patients stop treatment (for example, the cost of drugs or of transport to clinics) might reduce the number of patients lost to follow up. The researchers also suggest that HIV treatment programs with very high retention rates might serve as models to improve retention rates in other programs.
Citation: Rosen S, Fox MP, Gill CJ (2007) Patient retention in antiretroviral therapy programs in sub-Saharan Africa: A systematic review. PLoS Med 4(10): e298.