Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India
Aim: This article describes a cooperative initiative between an HIV-clinic and non-government organization network providing lost-to-follow-up tracing and delayed appointment follow-up of patients on antiretroviral treatment. Background: Loss-to-follow-up among patients on antiretroviral treatment...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
Blackwell Publishing Ltd
2012
|
| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/35747 |
| _version_ | 1848754579473170432 |
|---|---|
| author | Errol, L. Isaakidis, P. Zachariah, R. Ali, Mohammed Pilankar, G. Maurya, S. Geraets, Claudia |
| author_facet | Errol, L. Isaakidis, P. Zachariah, R. Ali, Mohammed Pilankar, G. Maurya, S. Geraets, Claudia |
| author_sort | Errol, L. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Aim: This article describes a cooperative initiative between an HIV-clinic and non-government organization network providing lost-to-follow-up tracing and delayed appointment follow-up of patients on antiretroviral treatment. Background: Loss-to-follow-up among patients on antiretroviral treatment is a major challenge in resource-constrained settings. A model of cooperation between a Médecins Sans Frontières HIV-clinic and a non-governmental-organization network was piloted in a Mumbai slum. A steady decline in delayed appointments and loss-to-follow-up was observed over 4 years. Design: Mixed method study. Methods: A study conducted in January 2011 explored potential reasons for declining loss-to-follow-up-rates. A retrospective, quantitative analysis of patient data was undertaken complemented by 22 semi-structured interviews, four focus-group discussions to explore patients’ and providers’ perceptions of tracing activities. Results/findings: The clinic loss-to-follow-up-rate has steadily declined from mid-2008–2011. Thirty-eight (4•6%) of 819 patients registered during the period were lost-to-follow-up with most lost during the first year. Rates of loss-to-follow-up between 0•3–2•4% were observed over the last 2 years. Phoning the day before an appointment was perceived as the most useful intervention to avoid missing appointments. The analysis revealed a widespread fear of forced disclosure by patients during home visits.Conclusions: The low loss-to-follow-up-rate cannot be attributed to the network tracing activities alone. Phoning before appointments may result in fewer delayed appointments and prevent loss-to-follow-up. Home visits should be a last resort method of patient tracing because of the risk of HIV-status disclosure and the opportunity of discrimination from family and neighbours. |
| first_indexed | 2025-11-14T08:42:39Z |
| format | Journal Article |
| id | curtin-20.500.11937-35747 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T08:42:39Z |
| publishDate | 2012 |
| publisher | Blackwell Publishing Ltd |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-357472018-03-29T09:09:00Z Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India Errol, L. Isaakidis, P. Zachariah, R. Ali, Mohammed Pilankar, G. Maurya, S. Geraets, Claudia HIV/AIDS loss-to-follow-up discrimination patient tracing HIV disclosure resource-limited settings nursing Aim: This article describes a cooperative initiative between an HIV-clinic and non-government organization network providing lost-to-follow-up tracing and delayed appointment follow-up of patients on antiretroviral treatment. Background: Loss-to-follow-up among patients on antiretroviral treatment is a major challenge in resource-constrained settings. A model of cooperation between a Médecins Sans Frontières HIV-clinic and a non-governmental-organization network was piloted in a Mumbai slum. A steady decline in delayed appointments and loss-to-follow-up was observed over 4 years. Design: Mixed method study. Methods: A study conducted in January 2011 explored potential reasons for declining loss-to-follow-up-rates. A retrospective, quantitative analysis of patient data was undertaken complemented by 22 semi-structured interviews, four focus-group discussions to explore patients’ and providers’ perceptions of tracing activities. Results/findings: The clinic loss-to-follow-up-rate has steadily declined from mid-2008–2011. Thirty-eight (4•6%) of 819 patients registered during the period were lost-to-follow-up with most lost during the first year. Rates of loss-to-follow-up between 0•3–2•4% were observed over the last 2 years. Phoning the day before an appointment was perceived as the most useful intervention to avoid missing appointments. The analysis revealed a widespread fear of forced disclosure by patients during home visits.Conclusions: The low loss-to-follow-up-rate cannot be attributed to the network tracing activities alone. Phoning before appointments may result in fewer delayed appointments and prevent loss-to-follow-up. Home visits should be a last resort method of patient tracing because of the risk of HIV-status disclosure and the opportunity of discrimination from family and neighbours. 2012 Journal Article http://hdl.handle.net/20.500.11937/35747 10.1111/j.1365-2648.2011.05934.x Blackwell Publishing Ltd restricted |
| spellingShingle | HIV/AIDS loss-to-follow-up discrimination patient tracing HIV disclosure resource-limited settings nursing Errol, L. Isaakidis, P. Zachariah, R. Ali, Mohammed Pilankar, G. Maurya, S. Geraets, Claudia Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India |
| title | Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India |
| title_full | Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India |
| title_fullStr | Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India |
| title_full_unstemmed | Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India |
| title_short | Tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in India |
| title_sort | tracing patients on antiretroviral treatment lost-to-follow-up in an urban slum in india |
| topic | HIV/AIDS loss-to-follow-up discrimination patient tracing HIV disclosure resource-limited settings nursing |
| url | http://hdl.handle.net/20.500.11937/35747 |