Abstract

BackgroundAlthough the simplification of antiretroviral (AVR) treatment regimens and follow-up has led to fewer constraints for patients with HIV, their follow-up remains of paramount importance to optimize AVR therapy, to detect and prevent HIV-related morbidity, and prevent secondary infections. The problem of follow-up interruption in French Guiana has been persistent and seemingly impervious to efforts to alleviate it.ObjectiveThe objective was to follow the trend of follow-up interruptions and to test the hypothesis that an increasing number of patients was, in fact, followed by private practitioners.MethodUsing the complementary lenses of the hospital HIV cohort and the health insurance information system, we looked at the incidence of follow-up interruption and the proportion of patients followed by private practitioners.ResultsWe tallied 803 persons that were not known to have died and who were lost to follow-up. Over time, hospital outpatients were lost to follow-up significantly sooner. By contrast, there was a significant trend with more and more patients exclusively followed by private practitioners.ConclusionWhile hospital outpatient care remains by far the most common mode of patient care, there seems to be a gradual erosion of this model in favor of private practice.

Highlights

  • French Guiana is the French overseas territory where the HIV epidemic is most prevalent [1]

  • The simplification of treatment regimens and follow-up has led to fewer constraints for the patients, their follow-up remains of paramount importance to optimize antiretroviral therapy to detect and prevent HIV-related morbidity and prevent secondary infections

  • In the post 90-90-90 context, French Guiana aims to optimize the cascade of care by improving early testing and treatment and retaining patients in the healthcare system so they can continue to benefit from virological suppression

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Summary

Introduction

French Guiana is the French overseas territory where the HIV epidemic is most prevalent [1]. The simplification of treatment regimens and follow-up has led to fewer constraints for the patients, their follow-up remains of paramount importance to optimize antiretroviral therapy to detect and prevent HIV-related morbidity and prevent secondary infections. In the post 90-90-90 context, French Guiana aims to optimize the cascade of care by improving early testing and treatment and retaining patients in the healthcare system so they can continue to benefit from virological suppression. Despite progress, this remains a problem in France [7, 8]. The problem of follow-up interruption in French Guiana has been persistent and seemingly impervious to efforts to alleviate it

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