- Blevins M, José E, Bilhete FR, Vaz LM, Audet CM, Shepherd BE, Vermund S, Moon TD. Two-year death and loss to follow-up outcomes by source of referral to HIV care for HIV-infected patients initiating antiretroviral therapy in rural Mozambique. AIDS research and human retroviruses. 2014 Nov 10. PMID: 25381732 [PubMed].
Introduction: We studied patient outcomes by type of referral site following two years of combination antiretroviral therapy (cART) during scale-up from June 2006-July 2011 in Mozambique's rural Zambézia Province. Methods: Loss to follow-up (LTFU) was defined as no contact within 60 days after scheduled medication pickup. Endpoints included LTFU, mortality, and combined mortality/LTFU; we used Kaplan-Meier and cumulative incidence estimates. Referral site was the source of HIV testing. We modeled 2-year outcomes using Cox regression stratified by district, adjusting for sociodemographics and health status. Results: Of 7,615 HIV-infected patients >15 years starting cART, 61% were female and median age was 30 years. Two-year LTFU was 38.1% (95%CI: 36.9-39.3%) and mortality was 14.2% (95%CI 13.2%-15.2%). Patients arrived from voluntary counseling and testing (VCT) sites (51%), general outpatient clinic (21%), antenatal care (8%), inpatient care (3%), HIV/tuberculosis/laboratory facilities (