Low retention rate of PLHIV at ART Centre: An insight into baseline data and associated factors from a cross sectional study in Kota zone, Rajasthan

Abstract

Background- Loss to follow-up (LFU) to ART is an independent risk factor for the development of drug resistanceamong persons living with HIV(PLHIV) resulting in treatment failure and mortality which is influenced by many complex factors. Thus Recognition of these influencing factors will help in reinforcing the conditions favoring adherence to ART. This study aimsto determine the various factors associated with LFU/OPTOUT and to identify the reasons of default from ART care.
Methodology-PLHIV aged ≥15 years who were initiated on ART between 1st January 2017 to 31st December 2020 at the selected ART centerand choose LFU/OPT OUT were included in study. These LFU/opted out PLHIV were contacted for semi-structured interview in the form of a pre structured questionnaire having open ended questions.
Results - The study showed that 86% of subjects were opted out and 14% were LFU. Maximum deviation was seen among subjects from age group 16-45 years, Low Socioeconomic status 88%(n=155), married 71% (n=122), low education level 85% (n=147). Other major factors for OPT OUT/LFU were private job, single earning family member, two or more dependent family members and residence more than 20km from ART Centre. 75%(n=130)opted out and 82%(n=23) LFUPLHIV were having CD4 count >250.54%opted out and 21%LFUs discontinued ART because of disturbance in daily pursuits due to ART centre visit.
Conclusion and recommendation - Study found that reasonfor opting out/LFU were multifactorial and goal-directed approach toward young adults (44% age group of 16-30years), low socioeconomic strata (88%), low educated subjects(85% primary education) wouldfind to be fruitful as these include the most deviated subjects