- Factors Associated With Long-term Retention in Antiretroviral Therapy Among People Living With HIV: Evidence From a Tertiary Hospital in Jakarta, Indonesia
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Ifael Yerosias Mauleti, Krishna Adi Wibisana, Djati Prasetio Syamsuridzal, Sri Mulyati, Vivi Lisdawati, Ika Saptarini, Nurhayati , Armedy Ronny Hasugian, Harimat Hendarwan
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J Prev Med Public Health. 2024;57(3):252-259. Published online April 30, 2024
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DOI: https://doi.org/10.3961/jpmph.23.512
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 Abstract
Summary
 PDF Supplementary 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.
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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.
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