Six-monthly appointment spacing for clinical visits as a model for retention in HIV Care in Conakry-Guinea: a cohort study
- Resource Type
- Authors
- Letizia Di Stefano; Jerome Mouton; Stéphanie Drèze; Ousseni W. Tiomtore; Cavin Epie Bekolo; Abdourahimi Diallo; Joseph-Desire Yuma; Youssouf Koita; Mit Philips
- Source
- BMC Infectious Diseases
BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-10 (2017)
- Subject
- Adult
Male
medicine.medical_specialty
030231 tropical medicine
HIV Infections
Disease
lcsh:Infectious and parasitic diseases
Disease Outbreaks
ART delivery
Cohort Studies
03 medical and health sciences
Appointments and Schedules
0302 clinical medicine
Health care
medicine
Humans
Tuberculosis
lcsh:RC109-216
Attrition
Ebola epidemic
030212 general & internal medicine
Proportional Hazards Models
Retrospective Studies
business.industry
Proportional hazards model
Retrospective cohort study
Hemorrhagic Fever, Ebola
Middle Aged
Viral Load
medicine.disease
CD4 Lymphocyte Count
Infectious Diseases
Anti-Retroviral Agents
Retention in HIV care
Tropical medicine
Emergency medicine
Guinea
Female
business
Viral load
Delivery of Health Care
Cohort study
Research Article
- Language
- English
- ISSN
- 1471-2334
Background The outbreak of the Ebola virus disease (EVD) in 2014 led to massive dropouts in HIV care in Guinea. Meanwhile, Médecins Sans Frontières (MSF) was implementing a six-monthly appointment spacing approach adapted locally as Rendez-vous de Six Mois (R6M) with an objective to improve retention in care. We sought to evaluate this innovative model of ART delivery in circumstances where access to healthcare is restricted. Methods A retrospective cohort study in 2014 of the outcome of a group of stable patients (viral load ≤1000 copies/μl) enrolled voluntarily in R6M compared with a group of stable patients continuing standard one to three monthly visits in Conakry. Log-rank test and Cox proportional hazards model were used to compare rates of attrition (deaths and defaulters) from care between the two groups. A linear regression analysis was used to describe the trend or pattern in the number of clinical visits over time. Results Included were 1957 adults of 15 years old and above of whom 1166 (59.6%) were enrolled in the R6M group and 791 (40.4%) in the standard care group. The proportion remaining in care at 18 months and beyond was 90% in the R6M group; significantly higher than the 75% observed in the control group (p