Abstract:
Background: Retention in care and adherence to the treatment is key indicator of the HIV
program effectiveness. HIV-infected patients who are lost to follow-up while on treatment
compromise their own health and the long-term achievement of antiretroviral therapy (ART)
plans. However, there is limited evidence on the determinants of lost to follow-up among
HIV infected patients ART in the study area.
Objective: Thus, this study was aimed to assess the determinants of loss to follow-up among
HIV-infected patients on ART at ART clinic of Tepi General Hospital, South West Ethiopia.
Method: Unmatched case control study was used among a total of 360 records of (120 cases
and 240 controls) patients who were registered on antiretroviral therapy in Tepi General
Hospital from January 1st, 2017 to December 30, 2019. Baseline patient records were
extracted from electronic data base and registration books. Statistical Analysis was done
using backward method and multivariable logistic regression model to identify the
determinants of loss to follow up among patients on ART. Level of statistical significance
was declared at p –value less than 0.05.
Results: After controlling for possible confounders, the independent variables that increased
lost to follow-up of patient were being male [AOR = 2.2, 95% CI: (1.27, 4.10)], being aged
15-24 years[AOR = 3.8, 95% CI (1.0, 14.5)],being rural resident [AOR = 2.2, 95% CI: (1.2,
3.9)],being single [AOR = 3.6, 95% CI: (1.9, 6.7)] ,baseline CD4count <500cells/ml[AOR =
4.2, 95% CI: (2.01, 8.5)] , not disclosing HIV status [AOR = 1.8, 95% CI: (1.0, 3.2)] having
WHO clinical stage three [AOR = 3.4, 95% CI: (1.6, 7.3)] and lack of telephone contact
[AOR = 1.9, 95% CI: (1.03, 3.6)].
Conclusion: The current study found that, being male, being single, being aged 15-24 years not disclosing HIV status, having baselineCD4 count<500cells/ml, being rural residents,
having WHO clinical stage three and four and lacking telephone contact at start of follow-up
were determinants of loss to follow-up from chronic HIV care. The findings of this study
have implications for patient support and monitoring in ART programs such as reengaging
those who have been lost to follow-up from ART. Clinicians working in ART care shall
consider the identified risk factors while giving ART service. Tracking the lost patients to
make the evidence more complete is recommended for future research
