Decentralizing ART Supply for Stable HIV Patients to Community-Based Distribution Centers: Program Outcomes From an Urban Context in Kinshasa, DRC

Florian Vogt, Lucien Kalenga, Jean Lukela, Freddy Salumu, Ibrahim Diallo, Elena Nico, Emmanuel Lampart, Rafael Van den Bergh, Safieh Shah, Olumide Ogundahunsi, Rony Zachariah, Johan Van Griensven

Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centers among 2603 patients with HIV in Kinshasa, Democratic Republic of Congo, using a multilevel Poisson regression model. Death, loss to follow-up, and transfer out were 0.3%, 9.0%, and 0.7%, respectively, at 24 months. Overall attrition was 5.66/100 person-years. Patients with >3 years on ART, >500 cluster of differentiation type-4 count, body mass index >18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centers are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage.

May 29, 2017
Year of publication
Resource types
Journal and research articles
facility-based HIV services, antiretroviral therapy, ARVs, ART, treatment, antiretroviral drugs, health facilities, decentralization, Democratic Republic of Congo (DRC), attrition, loss to follow-up, ART provision, community-based ART refill centers, stigma and discrimination, ART coverage

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