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Member Research & Reports

Member Research & Reports

BU Study: Retention Problems among South African Patients Receiving HIV Treatment

A new study led by a Boston University School of Public Health (BUSPH) researcher found that fewer than half of patients who tested HIV-positive at a Johannesburg, South Africa clinic returned to complete eligibility testing for antiretroviral therapy (ART), suggesting that “strategies to reduce attrition from all stages of care are urgently needed.”

The study, published in the journal PLoS ONE, tracked 380 patients at a clinic in Johannesburg who had tested positive for HIV. Researchers found no evidence that 142 of them returned for a blood draw — a CD4 count measuring levels of infection-fighting white-blood cells — that would determine eligibility for ART treatment. Of the remaining 238, only about 39 percent completed eligibility testing for ART within three months.

“While momentum for increasing treatment thresholds is growing, if patients cannot be retained in HIV care from the time of testing positive through long-term adherence to antiretroviral therapy, such strategies may fall short of expected gains,” said the research team, led by Dr. Matthew Fox, associate professor of epidemiology at BUSPH and a researcher at the Center for Global Health & Development. “These findings suggest that test-and-treat programs must focus on retention, particularly in the pre-ART period, in order to reduce morbidity, mortality, and transmission.

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