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AIDS and Behavior

, Volume 18, Issue 11, pp 2135–2143 | Cite as

Patient Outcomes in Lubumbashi, Democratic Republic of Congo After a Disruption in HIV Care Due to Decreased Global Fund Appropriations

  • Anna Freeman
  • Modeste Kiumbu
  • Blaise Mwamba
  • Joseph Atibu
  • Henri Mukumbi
  • Louis Mwila
  • Christopher Cummiskey
  • Kristen Stolka
  • Jennifer Hemingway-Foday
  • Jamie E. NewmanEmail author
Original Paper

Abstract

This study examines care seeking behaviors, clinical outcomes, and satisfaction with care of HIV-positive adults in Lubumbashi, DRC, one year after a disruption in care due to decreased global fund appropriations. We describe outcomes before and after the disruption. We compared characteristics of those who completed the survey and those who did not using the Wald F test. Most patients sought care after the disruption and continued antiretroviral therapy (ART), though use of cotrimoxizole prophylaxis declined. Though there was little change in WHO clinical stage at the new site of care, the majority of participants lost weight, adherence decreased, support group participation dropped, and satisfaction with care worsened. Patients were more likely to participate in the study if they were taking ART. This study highlights the importance of provider-patient communication during a transfer and the vulnerability of pre-ART patients to becoming lost to follow-up.

Keywords

HIV Africa Funds Delivery of health care Medication adherence 

Resumen

Este estudio analiza los comportamientos de búsqueda de atención, resultados clínicos y la satisfacción de adultos con VIH respecto a la atención recibida en Lubumbashi, RDC. El estudio se realizó un año después de la interrupción en la atención debido a la disminución en la partida de recursos del Fondo Mundial. Se describen los resultados antes y después de la interrupción. Comparamos las características de aquellos que completaron la encuesta con aquellos que no lo hicieron, usando la prueba F-Wald. La mayoría de los pacientes buscaron atención después de la interrupción y continuaron con la terapia antirretroviral (TAR), aunque el uso de profilaxis con cotrimoxazol declinó. A pesar del pequeño cambio en el OMS estadio clínico, en el nuevo lugar de atención, la mayoría de los participantes perdieron peso, la adherencia disminuyó, la participación en grupos de apoyo se redujo y la satisfacción con la atención empeoró. Los pacientes fueron más propensos a participar en el estudio si estaban tomando TAR. Este estudio resalta la importancia de la comunicación proveedor-paciente durante una transferencia y el riesgo de perder el seguimiento en pacientes pre-TAR.

Notes

Acknowledgments

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health under Award Number U01AI069927. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The International epidemiologic Databases to Evaluate AIDS (IeDEA) Central Africa region collaboration acknowledges the contribution of local staff and patients in this project, Dr. Robin Huebner of NIAID, and Ms. Jeniffer Iriondo-Perez at RTI International.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Anna Freeman
    • 1
  • Modeste Kiumbu
    • 2
  • Blaise Mwamba
    • 3
  • Joseph Atibu
    • 2
  • Henri Mukumbi
    • 4
  • Louis Mwila
    • 3
  • Christopher Cummiskey
    • 5
  • Kristen Stolka
    • 1
  • Jennifer Hemingway-Foday
    • 1
  • Jamie E. Newman
    • 1
    Email author
  1. 1.Statistics and EpidemiologyRTI InternationalResearch Triangle ParkUSA
  2. 2.Kinshasa School of Public HealthKinshasaDemocratic Republic of the Congo
  3. 3.AMO-CongoLubumbashiDemocratic Republic of the Congo
  4. 4.AMO-CongoKinshasaDemocratic Republic of the Congo
  5. 5.International Development GroupRTI InternationalWashingtonUSA

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