Long-term retention and predictors of attrition for key populations receiving antiretroviral treatment through community-based ART in Benue State Nigeria: A retrospective cohort study

• DOI: 10.1371/journal.pone.0260557
• Publication Date: 2021-11-30T21:02:48Z
• Authors: Olujuwon Ibiloye; Plang Jwanle; Caroline Masquillier; Sara Van Belle; Ekere Jaachi; Olubunmi Amoo; Ahmed Isah; Temiwoluwa Omole; Jay Osi Samuel; Josefien van Olmen; Lutgarde Lynen; Prosper Okonkwo; Tom Decroo
• Keywords: Outreach; Attrition

Background Key populations (KP) are disproportionately infected with HIV and experience barriers to care. KP include men who have sex (MSM), female workers (FSW), persons inject drugs (PWID) transgender people (TG). We implemented three different approaches the delivery of community-based antiretroviral therapy for (KP-CBART) in Benue State Nigeria, including One Stop Shop clinics (OSS), community drop-in-centres (DIC), outreach venues. OSS health facilities serving only. DIC small led by lay healthcare providers supported an team. Outreach venues places served studied long-term attrition virological non-suppression. Method This is a retrospective cohort study living (KPLHIV) starting ART between 2016 2019 3 0SS, 2 8 Attrition included lost follow-up (LTFU) death. A viral load >1000 copies/mL showed Survival analysis was used assess retention on ART. Cox regression Firth logistic were risk factors non-suppression respectively. Result Of 3495 KPLHIV initiated KP-CBART, 51.8% (n = 1812) enrolled OSS, 28.1% 982) DIC, 20.1% 701) through The majority participants FSW—54.2% 1896), while 29.8% 1040), 15.8% 551) 0.2% 8) MSM, PWID, TG overall programme 63.5%, 55.4%, 51.2%, 46.7% at 1 year, years, 4 years 1650 attrition, 2.5% 41) died others LTFU. Once adjusted other (age, sex, place residence, year enrollment, WHO clinical stage, type group, KP-CBART approach), approach did not predict attrition. MSM higher (vs FSW; hazard ratio (aHR) 1.27; 95%CI: 1.14–1.42). patients, 48.4% 1691) had test. those, 97.8% 1654) virally suppressed. Conclusion Although care low, suppression optimal retained However, testing coverage sub-optimal. Future research should explore perspectives clients reasons LTFU how adapt CBART meet individual client needs.