Risk Factors for Loss to Follow-Up among People Who Inject Drugs in a Risk Reduction Program at Karachi, Pakistan. A Case-Cohort Study.
PLoS One
; 11(2): e0147912, 2016.
Article
em En
| MEDLINE
| ID: mdl-26840414
ABSTRACT
INTRODUCTION:
Retention of male people who inject drugs (PWIDs) is a major challenge for harm reduction programs that include sterile needle/syringe exchange in resource-limited settings like Pakistan. We assessed the risk factors for loss to follow-up among male PWIDs enrolled in a risk reduction program in Karachi, Pakistan.METHODS:
We conducted a prospective cohort study among 636 HIV-uninfected male PWIDs enrolled during March-June 2009 in a harm reduction program for the estimation of incidence rate. At 24 months post-enrollment, clients who had dropped out of the program were defined as lost to follow-up and included as cases for case-cohort study.RESULTS:
The median age of the participants was 29 years (interquartile range 23-36). Active outreach accounted for 76% (483/636) of cohort recruits. Loss to follow-up at 24 months was 25.5% (162/636). In multivariable logistic regression, younger age (AOR 0.97, 95% CI 0.92-0.99, p = 0.028), clients from other provinces than Sindh (AOR 1.49, 95% CI 1.01-2.22, p = 0.046), having no formal education (AOR 3.44, 95% CI 2.35-4.90, p<0.001), a history of incarceration (AOR 1.68, 95% CI 1.14-2.46, p<0.008), and being homeless (AOR 1.47, 95% CI 1.00-2.19, p<0.049) were associated with loss to follow-up.CONCLUSIONS:
Our cohort retained 74.5% of male PWIDs in Karachi for 24 months. Its loss to follow up rate suggested substantial ongoing programmatic challenges. Programmatic enhancements are needed for the highest risk male PWIDs, i.e., younger men, men not from Sindh Province, men who are poorly educated, formerly incarcerated, and/or homeless.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Abuso de Substâncias por Via Intravenosa
/
Perda de Seguimento
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
PLoS One
Ano de publicação:
2016
Tipo de documento:
Article