Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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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 (Department of Internal Medicine, Fatmawati General Hospital) ;
  • Krishna Adi Wibisana (Department of Internal Medicine, Fatmawati General Hospital) ;
  • Djati Prasetio Syamsuridzal (General Practitioner Staff, Fatmawati General Hospital) ;
  • Sri Mulyati (General Practitioner Staff, Fatmawati General Hospital) ;
  • Vivi Lisdawati (Directorate of Human Resources, Education and Research, Fatmawati General Hospital) ;
  • Ika Saptarini (Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency) ;
  • Nurhayati (Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency) ;
  • Armedy Ronny Hasugian (Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency) ;
  • Harimat Hendarwan (Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency)
  • Received : 2023.11.12
  • Accepted : 2024.04.01
  • Published : 2024.05.31
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Abstract

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.

Keywords

Acknowledgement

The authors would like to express their gratitude to Fatmawati General Hospital for granting permission to use the data.

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