@article{fdi:010076589,
  title = {{R}etention in care trajectories of {HIV}-positive individuals participating in a universal test-and-treat program in rural {S}outh {A}frica ({ANRS} 12249 {T}as{P} {T}rial)},
  author = {{G}osset, {A}. and {P}rotopopescu, {C}. and {L}armarange, {J}oseph and {O}rne-{G}liemann, {J}. and {M}c{G}rath, {N}. and {P}illay, {D}. and {D}abis, {F}. and {I}wuji, {C}. and {B}oyer, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective: {T}o study retention in care ({RIC}) trajectories and associated factors in patients eligible for antiretroviral therapy ({ART}) in a universal test-and-treat setting ({T}as{P} trial, {S}outh {A}frica, 2012-2016). {D}esign: {A} cluster-randomized trial whereby individuals identified {HIV} positive after home-based testing were invited to initiate {ART} immediately (intervention) or following national guidelines (control). {M}ethods: {E}xiting care was defined as >= 3 months late for a clinic appointment, transferring elsewhere, or death. {G}roup-based trajectory modeling was performed to estimate {RIC} trajectories over 18 months and associated factors in 777 {ART}-eligible patients. {R}esults: {F}our {RIC} trajectory groups were identified: (1) group 1 "remained" in care (reference, n = 554, 71.3%), (2) group 2 exited care then "returned" after [median (interquartile range)] 4 (3-9) months (n = 40, 5.2%), (3) group 3 "exited care rapidly" [after 4 (4-6) months, n = 98, 12.6%], and (4) group 4 "exited care later" [after 11 (9-13) months, n = 85, 10.9%]. {G}roup 2 patients were less likely to have initiated {ART} within 1 month and more likely to be male, young (<29 years), without a regular partner, and to have a {CD}4 count >350 cells/mm(3). {G}roup 3 patients were more likely to be women without social support, newly diagnosed, young, and less likely to have initiated {ART} within 1 month. {G}roup 4 patients were more likely to be newly diagnosed and aged 39 years or younger. {C}onclusions: {H}igh {CD}4 counts at care initiation were not associated with a higher risk of exiting care. {P}rompt {ART} initiation and special support for young and newly diagnosed patients with {HIV} are needed to maximize {RIC}.},
  keywords = {universal test and treat ; {HIV} ; {S}outh {A}frica ; retention in care trajectories ; {AFRIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{JAIDS}.{J}ournal of {A}cquired {I}mmune {D}eficiency {S}yndromes},
  volume = {80},
  numero = {4},
  pages = {375--385},
  ISSN = {1525-4135},
  year = {2019},
  DOI = {10.1097/qai.0000000000001938},
  URL = {https://www.documentation.ird.fr/hor/fdi:010076589},
}