{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:29:20Z","timestamp":1765758560695,"version":"3.41.2"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T00:00:00Z","timestamp":1561593600000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 MH108427","R01 MH090326\u201003S1"],"award-info":[{"award-number":["R01 MH108427","R01 MH090326\u201003S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007301","name":"Harvard University Center for AIDS Research","doi-asserted-by":"publisher","award":["P30 AI060354"],"award-info":[{"award-number":["P30 AI060354"]}],"id":[{"id":"10.13039\/100007301","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005294","name":"Massachusetts General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005294","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Changes to the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) funding have led to closures of non\u2010governmental HIV clinics with patient transfers to government\u2010funded clinics. We sought to determine the success of transfers in South Africa using a national data source.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All adults (\u226518\u00a0years) on antiretroviral therapy (ART) who visited a single PEPFAR\u2010funded hospital\u2010based HIV clinic in Durban, South Africa from March to June 2012 were transferred to community\u2010based clinics. Previously, we matched patient records from the hospital\u2010based HIV clinic with National Health Laboratory Services (NHLS) Corporate Data Warehouse (CDW) data to estimate the proportion of patients with a CD4 count or viral load (VL) in the CDW during the year before transfer. As a proxy for retention in care, in this study we evaluated whether patients had a CD4 count or VL at another facility within approximately three years of transfer. Patients referred to a private doctor at transfer were excluded from the analysis. We assessed predictors (age, sex, CD4 count, VL status, ART duration and location of future care) of not having post\u2010transfer laboratory data using Cox proportional hazards models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 3893 patients referred to a government facility at transfer, 41% were male and median age was 39\u00a0years (IQR 34 to 46). There was a post\u2010transfer CD4 count or VL from another facility for 23% of these individuals within six months, 44% within one year, 57% within two years and 61% within approximately three years. Male sex (aHR 1.20, 95% CI 1.10 to 1.31) and shorter duration on ART (&lt;3\u00a0months, aHR 3.80, 95% CI 2.77 to 5.21; three months to one year, aHR 1.32, 95% CI 1.15 to 1.51, each compared with &gt;1\u00a0year) were associated with not having a post\u2010transfer record.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using data from the NHLS CDW, 61% of patients had evidence of a post\u2010transfer laboratory record at another facility within approximately three years after closure of a large South African HIV clinic. Males and those with shorter time on ART prior to transfer were at highest risk for lacking follow\u2010up laboratory data. As patients transfer care, national data sources can be used to evaluate long\u2010term patient care trajectories.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25326","type":"journal-article","created":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T08:02:47Z","timestamp":1561622567000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Using national laboratory data to assess cumulative frequency of linkage after transfer to community\u2010based HIV clinics in South Africa"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6920-6080","authenticated-orcid":false,"given":"Ingrid V","family":"Bassett","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Massachusetts General Hospital Boston MA USA"},{"name":"Division of General Internal Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Medical Practice Evaluation Center Department of Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard University Center for AIDS Research (CFAR) Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingshu","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Medical Practice Evaluation Center Department of Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard University Center for AIDS Research (CFAR) Boston MA USA"},{"name":"Biostatistics Center Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christie","family":"Cloete","sequence":"additional","affiliation":[{"name":"McCord Hospital Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sue","family":"Candy","sequence":"additional","affiliation":[{"name":"Department of Academic Affairs, Research and Quality Assurance Corporate Data Warehouse National Health Laboratory Services Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Giddy","sequence":"additional","affiliation":[{"name":"McCord Hospital Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone C","family":"Frank","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Medical Practice Evaluation Center Department of Medicine Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6471-7930","authenticated-orcid":false,"given":"Kenneth A","family":"Freedberg","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Massachusetts General Hospital Boston MA USA"},{"name":"Division of General Internal Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Medical Practice Evaluation Center Department of Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard University Center for AIDS Research (CFAR) Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Losina","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center Department of Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard University Center for AIDS Research (CFAR) Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"},{"name":"Departments of Biostatistics and Epidemiology Boston University School of Public Health Boston MA USA"},{"name":"Division of Rheumatology Department of Medicine, and Department of Orthopedic Surgery Brigham and Women's Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rochelle 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