Community-based ART distribution system can effectively facilitate long-term program retention and low-rates of death and virologic failure in rural Uganda.

摘要: Community-drug distribution point is a care model for stable patients in the community designed to make ART delivery more efficient health system and provide appropriate support encourage long-term retention of patients. We examined program among participants rural Uganda, which has used community-based since 2004. analyzed data all >18 years who initiated Jinja, Ugandan site The AIDS Support Organization between January 1, 2004 July 31, 2009. Participants attended clinic or outreach visits every 2–3 months had CD4 cell counts measured 6 months. Retention was defined as any patient with at least one visit 6 months before June 2013. then identified 2013 associations mortality lost-to-follow-up (LTFU). >4 years follow up during August, 2012 May, viral load conducted, no routine testing available. A total 3345 began 2004–2009. median time on 5.69 years. 1335 (40 %) were residents Jinja district 2005 (60 %) resided outlying districts. Of these, 2322 (69 %) retained care, 577 (17 %) died, 161 (5 %) transferred out 285 (9 %) LTFU. Factors associated LTFU included male gender, [Adjusted Hazard Ratio (AHR) = 1.56; 95 % CI 1.28–1.9], count <50 cells/μL (AHR = 4.09; 3.13–5.36) 50–199 (AHR = 1.86; 1.46–2.37); initiation WHO stages 3 (AHR = 1.35; 1.1–1.66) 4 (AHR = 1.74; 1.23–2.45). Residence outside not mortality/LTFU (p value = 0.562). 870 VL tests, 756 (87 %) VLs copies/mL. Community-based systems can effectively mitigate barriers result good rates virologic suppression.