Initial Research Design

Retention on ART not only improves individual health outcomes but also reduces HIV transmission. However, existing program evaluations and retention estimates are undermined by data gaps and misclassifications. My study aims to address these limitations by:

• Developing a predictive model for identifying at-risk patients.

• Informing evidence-based strategies to improve tracing and retention efforts.

• Enhancing program evaluations by accounting for silent transfers and misclassified outcomes.

Key Considerations for Implementation

• Challenges in Resource-Limited Settings: Addressing delays in tracing and improving documentation systems are critical priorities.

• Incorporation of Facility-Level Factors: Travel distance, cost, and waiting times are additional variables that may influence retention and attrition.

Research Design

Data Analysis

Data Sources: Analyze individual-level patient data, including variables such as time on ART, duration since the last clinic visit, WHO clinical stage of HIV progression, age, sex, and geographic location.

Objective: Identify factors associated with the four outcomes: attrition, silent transfers, continued care, and mortality.

Literature Review

Conduct a comprehensive review of existing studies to contextualize findings and identify gaps in understanding retention, attrition, and silent transfers among PLHIV on ART.

Survey of Healthcare Workers

Participants: Healthcare professionals working with LTFU patients.

Objective: Assess their perceptions of factors contributing to attrition, silent transfers, and mortality.

Topics Covered: Barriers to retention, challenges in tracing patients, and observations on factors affecting patient outcomes.