Retention throughout the HIV care and treatment cascade: From diagnosis to antiretroviral treatment of adults and children living with HIV - Haiti, 1985-2015

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

Abstract

Monitoring retention of people living with HIV (PLHIV) in the HIV care and treatment cascade is essential to guide program strategy and evaluate progress toward globally-endorsed 90-90-90 targets (i.e., 90% of PLHIV diagnosed, 81% on sustained antiretroviral therapy (ART), and 73% virally suppressed). We describe national retention from diagnosis throughout the cascade for patients receiving HIV services in Haiti during 1985-2015, with a focus on those receiving HIV services during 2008-2015. Among the 266,256 newly diagnosed PLHIV during 1985-2015, 49% were linked-to-care, 30% started ART, and 18% were retained on ART by the time of database closure. Similarly, among the 192,187 newly diagnosed HIV-positive patients during 2008-2015, 50% were linked to care, 31% started ART, and 19% were retained on ART by the time of database closure. Most patients (90-92%) at all cascade steps were adults (≥15 years old), among whomthe majority (60-61%) were female. During 2008-2015, outcomes varied significantly across 42 administrative districts (arrondissements) of residence; cumulative linkage-to-care ranged from23%to 69%, cumulative ART initiation among care enrollees ranged from 2% to 80%, and cumulative ART retention among ART enrollees ranged from 30%to 88%. Compared with adults, children had lower cumulative incidence of ART initiation among care enrollees (64% versus 47%) and lower cumulative retention among ART enrollees (64% versus 50%). Cumulative linkage-to-care was low and should be prioritized for improvement. Variations in outcomes by arrondissement and between adults and children require further investigation and programmatic response.

Original languageEnglish
Pages (from-to)57-70
Number of pages14
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume97
DOIs
StatePublished - Oct 2017

Bibliographical note

Funding Information:
Financial support: This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention.

Publisher Copyright:
Copyright © 2017 by The American Society of Tropical Medicine and Hygiene.

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Retention throughout the HIV care and treatment cascade: From diagnosis to antiretroviral treatment of adults and children living with HIV - Haiti, 1985-2015'. Together they form a unique fingerprint.

Cite this