Determinants of loss to follow-up in HIV care among adults on ART at Adama Hospital Medical College, Ethiopia: a case-control study.

BACKGROUND

In recent decades, the availability of antiretroviral therapy services has grown significantly, resulting in a reduction in both morbidity and mortality rates among patients undergoing treatment. Loss of follow-up remains a significant public health concern in Ethiopia notwithstanding these advancements. Earlier studies on loss to follow-up (LTFU) mainly used medical records and examined various factors that contribute to patient dropout across different regions. However, this study focused on data collected directly from patients. Therefore, this study aimed to identify the determinants of loss to follow-up among adult patients on ART at Adama Hospital Medical College, Oromia, Ethiopia, 2023.

METHODS

An unmatched case-control study was conducted on a sample size of 122 cases and 244 controls. Controls were approached using systematic random sampling method. The ART database was used to identify cases who were LTFU from the services for 90 days or longer from their last appointment date during the 24-month period prior to data collection and selected by simple random sampling. Data were collected by an interviewer-administered structured questionnaire by telephone call from cases and face-to-face interview from controls. The data were entered into Epi Info version 7.2 and analysed using SPSS version 26. Binary logistic regression analysis was conducted. The study findings were reported using adjusted odds ratios with a 95% confidence interval, and significance was determined using a P-value less than 0.05.

RESULTS

Not receiving IPT [AOR = 2.69; 95% CI: (1.86, 12.57)], not receiving CPT [AOR = 5.12; 95% CI: (2.60, 24.81)], TB/HIV co-infection [AOR = 8.42; 95% CI: (6.00, 19.59)], perceived stigma and discrimination [AOR = 2.44; 95% CI: (2.27, 13.18)], and not being a member of a PLHIV association [AOR = 4.71; 95% CI: (3.01, 11.26)] were the determinants of loss to follow-up.

CONCLUSION

Failure to receive IPT and CPT, perceived stigma and discrimination, TB/HIV co-infection, and not being a member of a PLHIV association were the determinants of loss to follow-up among people living with HIV. Relevant authorities should prioritize addressing these factors to enhance patient retention in care and improve treatment outcomes. CLINICAL TRIAL NUMBER: Not applicable.