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Journal Article > Short ReportFull Text

Decentralizing ART supply for stable HIV patients to community-based distribution centers: program outcomes from an urban context in Kinshasa, DRC

J Acquir Immune Defic Syndr. 1 March 2017; Volume 74 (Issue 3); 326-331.; DOI:10.1097/QAI.0000000000001215
Vogt F, Kalenga L, Lukela J, Salumu F, Diallo I,  et al.
J Acquir Immune Defic Syndr. 1 March 2017; Volume 74 (Issue 3); 326-331.; DOI:10.1097/QAI.0000000000001215
Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centers among 2603 patients with HIV in Kinshasa, Democratic Republic of Congo, using a multilevel Poisson regression model. Death, loss to follow-up, and transfer out were 0.3%, 9.0%, and 0.7%, respectively, at 24 months. Overall attrition was 5.66/100 person-years. Patients with >3 years on ART, >500 cluster of differentiation type-4 count, body mass index >18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centers are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage. More