We describe patterns of engagement in HIV care during the first year after treatment initiation. [...] In this study, we used retrospective medical record data from three provinces in South Africa to analyze patterns of care between ART initiation, 6 months after initiation, and 12 months after initiation. [...] We used visit attendance to describe patterns of engagement in care and viral suppression during the first year on ART. [...] We then used these visit classifications to specify a set of engagement patterns for the peri- ods from 0–6 months after initiation and from 7–12 months after initiation, as defined in Table 2 and summarized graphically in Fig 1. [...] Classification of visit types during the first six and twelve months after ART initiation, by engagement pattern. [...] Classification of visit types and engagement patterns during the first and second six months after ART initiation stratified by age group. [...] We noted that, overall, cyclical engagers were less likely to have VL results observed and also less likely to have a suppressed VL at 12 months compared to those continuously engaged in care during the first 6 months of treatment. [...] Cyclical and disengagement outcomes by 6 months on ART, more- over, were frequently preceded by multiple occurrences of visits attended late, suggesting opportunities to intervene with clients at risk of disengagement may be missed in the early ART period if visit patterns are not recognized. [...] Indeed, cyclical engagers were less likely to have a viral load done during the first year on ART compared to their counterparts who were continuously engaged in care and therefore had lower documented rates of viral suppression as a group. [...] Classification of visit types and engagement patterns during the first and second six months after ART initiation, stratified by gender. (DOCX) S4 Table.
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- Pages
- 19
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- South Africa
