Retention in care among older adults living with HIV in western Kenya: A retrospective observational cohort study

in africa •  7 years ago 

By a News Reporter-Staff News Editor at Nursing Home & Elder Business Week -- Data detailed on Immune System Diseases and Conditions - HIV/AIDS have been presented. According to news reporting from Eldoret, Kenya, by NewsRx journalists, research stated, “Retention, defined as continuous engagement in care, is an important indicator for quality of healthcare services. To achieve UNAIDS 90-90-90 targets, emphasis on retention as a predictor of viral suppression in patients initiated on ART is vital.”

The news correspondents obtained a quote from the research from Moi University, “Using routinely collected clinical data, the authors sought to determine the effect of age on retention post ART initiation. De-identified electronic data for 32965 HIV-infected persons aged {{>=}}15 years at enrolment into the Academic Model Providing Access to Healthcare program between January 2008 and December 2014 were analyzed. Follow-up time was defined from the date of ART initiation until either loss to follow-up or death or close of the database (September 2016) was observed. Proportions were compared using Pearson’s Chi-square test and medians using Mann-Whitney U test. Logistic regression model was used to assess differences in ART initiation between groups, adjusting for baseline characteristics. Cox proportional hazards model adjusting for baseline characteristics and antiretroviral therapy (ART) status was used to compute hazard ratios. Kaplan-Meier survival function was used to compare retention on ART at 12, 24, and 36 months post ART initiation. Of the total sample, 3924 (12.0%) were aged {{>=}}50 years at enrolment. The median (IQR) age of young adults and older adults were 32.5 (26.6, 36.9) and 54.9 (51.7, 59.9) respectively. ART initiation rates were 70.5% among older adults and 68.2% among younger adults. Retention rates in care at 12, 24 and 36 months post ART initiation were 73.9% (95% CL: 72.2, 75.5), 62.9% (95% CL: 61.0, 64.7) and 55.4% (95% CL: 53.5, 57.3) among older adults compared to 69.8% (95% CL: 69.1, 70.4), 58.1% (95% CL: 57.4, 58.8) and 49.3% (95% CL: 48.6, 50.0) among younger adults (p <0.001). A higher proportion of older adults were retained in HIV care post ART initiation compared to younger adults, Adjusted Hazard Ratio (AHR): 0.83 (95% CI: 0.78, 0.87) though they were more likely to die, AHR: 1.35 (95% CI: 1.19, 1.52). A higher proportion of older adults are initiated on ART and have better retention in care at 12, 24 and 36 months post ART initiation than younger adults. However, older adults have a higher all-cause mortality rate, perhaps partially driven by late presentation to care.”

According to the news reporters, the research concluded: “Enhanced outreach and care to this group is imperative to improve their outcomes.”

For more information on this research see: Retention in care among older adults living with HIV in western Kenya: A retrospective observational cohort study. Plos One , 2018;13(3):e0194047. (Public Library of Science - www.plos.org; Plos One - www.plosone.org)

Our news journalists report that additional information may be obtained by contacting J. Kiplagat, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya. Additional authors for this research include A. Mwangi, A. Keter, P. Braitstein, E. Sang, J. Negin and C. Chasela.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1371/journal.pone.0194047. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Our reports deliver fact-based news of research and discoveries from around the world. Copyright 2018, NewsRx LLC

CITATION: (2018-04-22), Researchers at Moi University Describe Findings in HIV/AIDS (Retention in care among older adults living with HIV in western Kenya: A retrospective observational cohort study), Nursing Home & Elder Business Week, 198, ISSN: 1552-2571, BUTTER® ID: 015486046

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