ART Attrition across Health Facilities Implementing Option B+ in Haiti. (16th May 2018)

• Record Type: Journal Article
• Authors: Myrtil, Martine Pamphile; Puttkammer, Nancy; Gloyd, Stephen; Robinson, Julia; Yuhas, Krista; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner
• Is Part Of: Journal of the International Association of Providers of AIDS Care. Volume 17(2018)
• Publication Date: 2018-05-16
• Subjects: Option B+ -- ART attrition -- health facility–level risk factors; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1177/2325958218774037
• Languages: English
• ISSNs: 2325-9574

Abstract

Background: Describing factors related to high attrition is important in order to improve the implementation of the Option B+ strategy in Haiti. Methods: We conducted a retrospective cohort study to describe the variability of antiretroviral therapy (ART) retention across health facilities among pregnant and lactating women and assess for differences in ART retention between Option B+ clients and other ART patients. Results: There were 1989 Option B+ clients who initiated ART in 45 health facilities. The percentage of attrition varied from 9% to 81% across the facilities. The largest health facilities had 38% higher risk of attrition (relative risk [RR]: 1.38, 95% confidence interval [CI]: 1.08-1.77, P = .009). Private institutions had 18% less risk of attrition (RR: 0.82, 95% CI: 0.70-0.96, P = .020). Health facilities located in the West department and the South region had lower risk of attrition. Conclusion: Being on treatment in a large or public health facility or a facility located in the North region was a significant risk factor associated with high attrition among Option B+ clients. The implementation of the Option B+ strategy must be reevaluated in order to effectively eliminate mother-to-child HIV transmission.