Incidence and Predictors of Loss to Follow-Up among Adult HIV Patients on Antiretroviral Therapy at Public Health Facilities In Metekel Zone, North West Ethiopia.

Abstract

Background: Antiretroviral therapy services have rapidly expanded, yet one of the main causes of HIV/AIDS programs' underwhelming results—drug resistance, morbidity, and mortality-is "lost to follow up." Studies carried out in various parts of the country reveal a high incidence and inconsistent contributing factors. However, the study area's information about the incidence and determinants of loss to follow-up is not adequately addressed. Objective: To assess incidence and predictors of loss to follow-up among HIV-infected adults receiving antiretroviral treatment at public health facilities in Metekel zone, Northwest Ethiopia. Methods: A retrospective cohort study at the institution was carried out from June 20 to July 5, 2022. Between June 28, 2017, and June 27, 2022, 540 adults who were receiving antiretroviral therapy at public health facilities in the Metekel zone were contacted. Data from the patient's chart were collected using a data abstraction tool. Based on the proportion of ART follow up at public health institutions, the samples from registration were chosen using a straightforward random sampling procedure. Epi Data version 3.1 was used to clean, enter, and export data, which was then exported to STATA 15 for analysis. To calculate the mean survival time and the difference in loss to follow-up between categorical variables, Kaplan-Meir curves and the log rank test were used. Result: In this study overall incidence rate of loss to follow-up were 15.12 (95% CI: 12.9-17.6) per 100 person-year. Significant predictors of loss to follow-up were; having tuberculosis at baseline [AHR=2.12, 95% CI, (1.33−3.38)], being underweight at baseline [AHR=5.36, 95% CI, (3.46–8.31)], poor adherence to antiretroviral treatment [AHR =2.14, 95% CI, (1.32−3.46)] and viral load result of >1000 copies/mL [AHR =2.71, 95% CI, (1.55 −4.72)]. Conclusion and recommendation: The finding of this study showed that the incidence of loss to follow-up among adults receiving antiretroviral therapy was high as compared to previous studies. Hence, special emphasis and close follow-up should be given to patients those having tuberculosis at baseline, poor adherence level, underweight at baseline and recent high viral load in the first year of treatment initiation.