Retention in care among people living with human immunodeficiency virus (HIV) in a low-resource setting

Ahmed Cordie; Rahma Mohamed; Ammar Hatem; Mahmoud Essam; Shaker Wagih Shaltout; Naeema El Garhy; Lamiaa Al Sehemy; Mirella Sherif; Reham Awad Awad; Mariam Ismail Abdelraouf; Aya M Al-Sharif; Ahmed Ramadan; Sahar Hassany; Engy El Khateeb; Amal M Sayed; Zainab Wafik Zakaria Masoud; Rania Soliman Hamza; Hend Hamed Tamim; Mona Salah Eldin Hamdy; Gamal Esmat; Haidi Karam-Allah Ramadan

doi:10.1177/09564624241306152

Retention in care among people living with human immunodeficiency virus (HIV) in a low-resource setting

Int J STD AIDS. 2024 Dec 10:9564624241306152. doi: 10.1177/09564624241306152. Online ahead of print.

Authors

Ahmed Cordie^{1

2}, Rahma Mohamed^{1

2}, Ammar Hatem¹, Mahmoud Essam¹, Shaker Wagih Shaltout³, Naeema El Garhy¹, Lamiaa Al Sehemy¹, Mirella Sherif¹, Reham Awad Awad¹, Mariam Ismail Abdelraouf¹, Aya M Al-Sharif¹, Ahmed Ramadan⁴, Sahar Hassany⁵, Engy El Khateeb⁶, Amal M Sayed⁶, Zainab Wafik Zakaria Masoud⁶, Rania Soliman Hamza⁶, Hend Hamed Tamim⁶, Mona Salah Eldin Hamdy⁶, Gamal Esmat^{1

7}, Haidi Karam-Allah Ramadan⁵

Affiliations

¹ Endemic Medicine Department, Cairo University, Cairo, Egypt.
² Kasr Al-Aini HIV and Viral Hepatitis Fighting Group, Cairo University Hospitals, Cairo University, Cairo, Egypt.
³ Tropical Medicine Department, Port Said University, Port Said, Egypt.
⁴ Department of Chemical & Biotechnology Engineering, Sherbrooke, Faculty of Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada.
⁵ Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt.
⁶ Department of Clinical and Chemical Pathology, Cairo University, Cairo, Egypt.
⁷ Badr University in Cairo, Research Center, Badr City, Cairo, Egypt.

PMID: 39655701
DOI: 10.1177/09564624241306152

Abstract

Background: This study aimed to evaluate the retention in care among a cohort of Egyptian people living with HIV (PLWHIV).

Method: The study was conducted on PLWHIV attending Kasr Alainy HIV and Viral Hepatitis Centre, Cairo, Egypt, from January 1, 2019, to March 31, 2023. PLWHIV were considered not retained in care if there was no documented clinical visit or HIV viral load (VL) or CD4 count test for more than 6 months from their last recorded visit or test. Multivariable logistic regression analysis was used to test factors associated with retention in care.

Results: After excluding those who died and were referred, 369 PLWHIV were included in the analysis, and retention in care was observed in 325 (88%). The majority were males (81.8%) with a median age of 34 [29-41] years. Undetectable VL (OR: 3.555; 95% CI: 1.49-8.47), hepatitis B vaccination (OR: 2.835; 95% CI: 1.07-7.48), CD4 test availability (OR: 2.604; 95% CI: 1.02-6.64), receiving dolutegravir based antiretroviral therapy (OR: 2.429; 95% CI: 1.06-5.537), and longer duration of know HIV infection (OR: 1.025; 95% CI: 1.01- 1.04) were correlated with retention in care. Surprisingly, higher education levels were negatively correlated with retention in care (OR: 0.195, 95%: CI: 0.071-0.533), suggesting the need for further research to explore this relationship.

Conclusion: These results are invaluable for developing targeted interventions and informing health policies to improve retention in HIV care in Egypt. Enhancing access to VL and CD4 testing, promoting VL suppression, and focusing on specific groups at risk of dropping out of care are essential strategies.

Keywords: Retention in care; human immunodeficiency virus; low-resource setting; mortality; viral load.