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Antiretroviral therapy (ART) for HIV/AIDS requires a lifelong commitment
from patients as well as providers. For
individual patients, both adherence to a specific treatment regimen and
retention in the treatment program are essential to success. In this study, we will investigate the
reasons for and determinants of long-term patient retention. The study will
1) estimate the rate of ART
patient retention and attrition at public and NGO treatment sites in South
Africa during the first three years after initiating ART;
2) describe the main
reasons for attrition for patients with different characteristics and receiving
care from different types of facilities; and
3) determine whether the
probability of dropping out varies with specific patient characteristics.
Patients at an urban hospital and a rural clinic in South Africa
who have been on ART for at least six months will be enrolled in the study and
administered a baseline questionnaire focusing on issues that are hypothesized
to affect retention (e.g. costs, side effects, stigma). A follow-up status review will be conducted
12 months later. Patients who have
dropped out of the program will be located using contact information collected
at the baseline interview and interviewed again to determine reasons for
discontinuation. Findings from the study
will improve the information available for ART programme design, patient care,
and public sector planning. By identifying
rates of and reasons for patient attrition, the study allow better targeting of
interventions, indicate whether the therapeutic regimen itself can be improved
to promote patient retention, and provide more accurate information on expected
numbers of patients in later years of the ART rollout.
Sydney Rosen is the Principal
Investigator and Dr. Ian Sanne and Dr. Candace Miller are co-Investigators.
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