Reasons for Lost to Follow-up of People Living with HIV on Antiretroviral Therapy in Bhavnagar

Abstract

Background
Anti-retroviral therapy (ART) aims to achieve sustained viral suppression and immune restoration. Understanding reasons for loss-to-follow-up (LFU) and associated factors is essential to improve adherence interventions and strengthen HIV care outcomes. The study amied to assess the profile of lost-to-follow-up people living with HIV on antiretroviral therapy at the ART Plus Centre of Sir Takhtsinhji Hospital, Bhavnagar, and to explore the reasons for loss to follow-up.
Methods
A mixed-method study was conducted from November 2022 to March 2023 at the ART Plus Centre. Data regarding 263 PLHIV patients who were lost to follow-up during the previous five years (2018-22) were obtained from the ART Plus Center Bhavnagar. Qualitative data were collected through face-to-face interviews using in-depth interview (IDI) guides among 19 purposively selected participants. Quantitative data were summarised using frequencies, while thematic analysis was performed for the qualitative component.
Results
A majority of the LFU patients (40.97%) were from Bhavnagar taluka. Migration was found to be a major factor (33.33%) for lost-to-follow-up patients, followed by inability to track due to an incorrect address given by patients (30.85%) and death (4.48%) on secondary data analysis. Factors related to four main themes socio-economic, work-related, medication and ART centre related were reported as reasons for lost to follow-up in a qualitative study.
Conclusions
The major reasons for lost-to-follow-up as perceived by LFU PLHIVs of Bhavnagar were no felt need of medicine, side effects of medicine and poor support from the ART centre.