RESUMO
Poor retention in care is common among HIV-positive adults in sub-Saharan Africa settings and remains a key barrier to HIV management. We quantify the associations of disclosure of HIV status and referral to disclosure counseling with successful retention in care using data from three Cameroon clinics participating in the Phase 1 International epidemiologic Databases to Evaluate AIDS Central Africa cohort. Of 1646 patients newly initiating antiretroviral therapy between January 2008 and January 2011, 43% were retained in care following treatment initiation. Self-disclosure of HIV status to at least one person prior to treatment initiation was associated with a minimal increase in the likelihood of being retained in care (risk ratio [RR] = 1.14; 95% confidence interval (CI): 0.94, 1.38). However, referral to disclosure counseling was associated with a moderate increase in retention (RR = 1.37; 95% CI: 1.21, 1.55) and was not significantly modified by prior disclosure status (p = .3). Our results suggest that while self-disclosure may not significantly improve retention among patients receiving care at these Cameroon sites, counseling services may play an important role regardless of prior disclosure status.
Assuntos
Antirretrovirais/uso terapêutico , Aconselhamento , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Autorrevelação , Revelação da Verdade , Adulto , Camarões , Estudos de Coortes , Feminino , Infecções por HIV/etnologia , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Cooperação do PacienteAssuntos
Infecções Oportunistas Relacionadas com a AIDS , Prestação Integrada de Cuidados de Saúde , Infecções por HIV/complicações , Sarcoma de Kaposi/patologia , Neoplasias Cutâneas/patologia , África Subsaariana , Biópsia , Botsuana , Dermatologia , Saúde Global , Humanos , Quênia , Nigéria , Encaminhamento e Consulta , Sarcoma de Kaposi/diagnóstico , Neoplasias Cutâneas/diagnósticoRESUMO
Sub-Saharan Africa has the largest number of individuals leaving with HIV/AIDS. However, much is still unknown as regards HIV/AIDS treatment outcomes in resource-constrained settings. The Cameroon Central Africa International Epidemiologic Databases to Evaluate AIDS-Cameroon (Cameroon CA-IeDEA) collaboration is a unique opportunity to explore long-term outcomes from a large HIV cohort and generate massive data that can show trends, inform HIV care and provide insight on the way forward. Given the lack of research capacity in the country, the need for high impact training that can leverage Cameroon CA-IeDEA has never been more acute.