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Nurhayati 1 Article
Factors Associated With Long-term Retention in Antiretroviral Therapy Among People Living With HIV: Evidence From a Tertiary Hospital in Jakarta, Indonesia
Ifael Yerosias Mauleti, Krishna Adi Wibisana, Djati Prasetio Syamsuridzal, Sri Mulyati, Vivi Lisdawati, Ika Saptarini, Nurhayati , Armedy Ronny Hasugian, Harimat Hendarwan
J Prev Med Public Health. 2024;57(3):252-259.   Published online April 30, 2024
DOI: https://doi.org/10.3961/jpmph.23.512
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment.
Methods
A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years.
Results
In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72).
Conclusions
Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.
Summary
Key Message
The administration of antiretroviral therapy to HIV patients has resulted in increased rates of survival, enhanced quality of life, and less transmission of the virus. Nevertheless, a negative correlation exists between the length of antiretroviral therapy and patient retention in care. Our study used data from a tertiary hospital and indicated a decrease in the retention rate of antiretroviral therapy over the third year. Retention was associated with the CD4 count, year of enrollment, and the use of an efavirenz-based treatment. Emphasizing patient engagement has been a longstanding focus in HIV programs, with initiatives being implemented to tackle this matter.

JPMPH : Journal of Preventive Medicine and Public Health