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Baseline and Process Factors of Anti-Retroviral Therapy That Predict Loss to Follow-up Among People Living with HIV/AIDS in China: A Retrospective Cohort Study

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Abstract

We explored the predictors and predictive models of loss to follow-up (LTFU) during the first year of anti-retroviral therapy (ART). LTFU was defined as the failure to visit the clinic for antiretroviral drugs for ≥ 90 days after the last missed scheduled visit. Based on the electronic medical records of 5953 patients who were HIV positive and began ART between 2016 and 2019 in China, the LTFU rate was 7.24 (95% confidence interval 6.49–7.97) per 100 person-years during the first year of ART. ART baseline factors were associated with LTFU, but were non-optimal predictors. A model including ART process-related factors such as follow-up behaviors and physical health status had an area under the receiver operating characteristic curve of 73.4% for predicting LTFU. Therefore, the medical records of follow-up visits can be used to identify patients with a high risk of LTFU and allow interventions to be implemented proactively.

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Funding

This study was funded by the National Natural Science Foundation of China (Grant No. 71774178), Science and Technology Planning Project of Guangdong (Grant No. 2017A020212006), the National Science and Technology Major Project of the Ministry of Science and Technology of China (Grant No. 2018ZX10715004), Chinese 13th Five-Year National Science and Technology Major Project (2018ZX10302103-002, 2017ZX10202101-003), and the Major Project of Health Care Collaborative Innovation of Guangzhou Science and Technology Innovation Commission (201803040002).

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  1. Jinzhao Xie and Jing Gu have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China

    Jinzhao Xie, Jing Gu, Xiuyuan Chen, Chun Hao & Yuantao Hao

  2. Department of Infectious Diseases, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China

    Cong Liu, Haidan Zhong, Peishan Du, Quanmin Li, Linghua Li & Weiping Cai

  3. School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China

    Joseph T. F. Lau

  4. Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, 510080, China

    Jing Gu

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  1. Jinzhao Xie
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Contributions

JG, LL, and JX developed the research questions, designed the study. LL, WC, CL, HZ, PD, and QL contributed to the acquisition of the data. JX and XC conducted the data analyses for this manuscript. JX and JG wrote the manuscript. CL, HZ, PD, and QL assisted with the interpretation of the data. CH, JTL, YH and WC revised the manuscript. All authors critically reviewed and edited the manuscript.

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Correspondence to Jing Gu or Linghua Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board (IRB) of the School of Public Health, Sun Yat-sen University, Guangzhou, China (No. 2019-139).

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Xie, J., Gu, J., Chen, X. et al. Baseline and Process Factors of Anti-Retroviral Therapy That Predict Loss to Follow-up Among People Living with HIV/AIDS in China: A Retrospective Cohort Study. AIDS Behav 26, 1126–1137 (2022). https://doi.org/10.1007/s10461-021-03466-8

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