Risk factors for loss to follow-up in HIV care: A retrospective cohort study in Dili, Timor-Leste

Benigna Veneranda da Costa Amaral Amaral; Joon Sup Yeom; Filipe de Neri Machado; Mariano da Silva Marques; Noel Gama Soares

doi:10.70347/svsthya.v2i5.141

Authors

Benigna Veneranda da Costa Amaral Amaral Graduate School of Public Health, Yonsei University, South Korea; National Institution of Public Health Timor-Leste (INSP-TL) https://orcid.org/0009-0006-0901-2552
Joon Sup Yeom Department of Global Health and Disease Control, Division of Infectious Disease Control, Yonsei University, South Korea
Filipe de Neri Machado National Institution of Public Health Timor-Leste (INSP-TL)
Mariano da Silva Marques National Institution of Public Health Timor-Leste (INSP-TL)
Noel Gama Soares National Institution of Public Health Timor-Leste (INSP-TL)

DOI:

https://doi.org/10.70347/svsthya.v2i5.141

Keywords:

HIV, loss to follow-up, antiretroviral therapy, Timor-Leste, patient retention, infectious disease

Abstract

Loss to follow-up (LTFU) among people living with HIV/AIDS (PLWHA) is a public health challenge that reduces the effectiveness of antiretroviral therapy (ART), increases the risk of transmission, and contributes to increased mortality. This study aimed to identify the risk factors for LTFU among patients with HIV in Dili, Timor-Leste. This retrospective cohort study used secondary data from 150 HIV-positive patients at the Community Progress Association (AK-P) in Dili from 2014 to 2022. The inclusion criterion was adult patients aged ≥ 15 years who started ART with a minimum follow-up of 183 days. Descriptive statistics, chi-square tests, logistic regression, and Kaplan‒Meier analysis were used to identify the factors affecting LTFU. Of the 150 patients, 72% remained under care, 20.6% experienced LTFU, and 7.3% died. The majority were male (90%), with men who had sex with men (MSM) having a 40% lower risk of LTFU than female sex workers (FSW). Patients aged ≥54 years had a 21% lower risk, and married individuals had a 26% lower risk than single individuals did. High income and ART initiation were protective factors, while a CD⁴ count <200 cells/mm³ increased the risk of LTFU by 4.2 times, and a viral load >1000 copies/mL increased the risk by 2.79 times. Level 1 ART was associated with 97% survival at 1, 3, and 5 years, whereas level 2 ART was associated with only 3.6% survival in the first year. Sociodemographic and clinical variables influenced LTFU in HIV care in Timor-Leste.

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Author Biographies

Benigna Veneranda da Costa Amaral Amaral, Graduate School of Public Health, Yonsei University, South Korea; National Institution of Public Health Timor-Leste (INSP-TL)

Graduate School of Public Health, Yonsei University, South Korea; National Institution of Public Health Timor-Leste (INSP-TL)

Joon Sup Yeom, Department of Global Health and Disease Control, Division of Infectious Disease Control, Yonsei University, South Korea

Department of Global Health and Disease Control, Division of Infectious Disease Control, Yonsei University, South Korea

Filipe de Neri Machado, National Institution of Public Health Timor-Leste (INSP-TL)

National Institution of Public Health Timor-Leste (INSP-TL)

Mariano da Silva Marques, National Institution of Public Health Timor-Leste (INSP-TL)

National Institution of Public Health Timor-Leste (INSP-TL)

Noel Gama Soares, National Institution of Public Health Timor-Leste (INSP-TL)

National Institution of Public Health Timor-Leste (INSP-TL)

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