Predictors of retention in the prospective HIV prevention OKAPI cohort in Kinshasa

S Carlos,C Lopez-Del Burgo,A Osorio,B Makonda,A Ndarabu,G Reina,J De Irala,E Burgueño

doi:10.1038/s41598-021-84839-w

Abstract

Retention is a key element in HIV prevention programs. In Sub-Saharan Africa most data on retention come from HIV clinical trials or people living with HIV attending HIV treatment and control programs. Data from observational cohorts are less frequent. Retention at 6-/12-month follow-up and its predictors were analyzed in OKAPI prospective cohort. From April 2016 to April 2018, 797 participants aged 15–59 years attending HIV Voluntary Counseling and Testing in Kinshasa were interviewed about HIV-related knowledge and behaviors at baseline and at 6- and 12-month follow-ups. Retention rates were 57% and 27% at 6- and 12-month follow up; 22% of participants attended both visits. Retention at 6-month was significantly associated with 12-month retention. Retention was associated with low economic status, being studying, daily/weekly Internet access, previous HIV tests and aiming to share HIV test with partner. Contrarily, perceiving a good health, living far from an antiretroviral center, daily/weekly alcohol consumption and perceiving frequent HIV information were inversely associated with retention. In conclusion, a high attrition was found among people attending HIV testing participating in a prospective cohort in Kinshasa. Considering the low retention rates and the predictors found in this study, more HIV cohort studies in Kinshasa need to be evaluated to identify local factors and strategies that could improve retention if needed.

Highlights

Despite a 28% decline in new HIV infections in Eastern and Southern Africa from 2010 to 2018 and of 13% in Western and Central Africa, there are still 25.6 million people living with HIV in Sub-Saharan Africa (SSA), a region where 61% of new infections worldwide take place[1]
The problem of attrition among people living with HIV still not under ARV treatment or among participants in prospective observational cohorts has been less frequently e valuated[5,14,15,16]
From April 2016 to April 2018, 797 participants were included in the cohort

Summary

Introduction

Despite a 28% decline in new HIV infections in Eastern and Southern Africa from 2010 to 2018 and of 13% in Western and Central Africa, there are still 25.6 million people living with HIV in Sub-Saharan Africa (SSA), a region where 61% of new infections worldwide take place[1] These figures show that there has been an insufficient progress in the prevention, treatment and control of HIV. In SSA, most published research on retention and related factors show data from clinical trials or from people living with HIV within the HIV continuum of care. Observational studies can show the real-world context outside the controlled protocols of clinical trials They can help to properly design preventive interventions, and to improve their feasibility, uptake, acceptability and efficiency[17,18,19,20]. Longitudinal observational studies can provide information concerning loss to followup (LTFU) and their predictors, which is relevant for the implementation of HIV preventive strategies, and to improve the quality of the data obtained[21]

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Results

Conclusion