{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:15:41Z","timestamp":1791224141734,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,30]],"date-time":"2018-09-30T00:00:00Z","timestamp":1538265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2019,1]]},"abstract":"Objectives<\/jats:title>Risk factors for loss to follow\u2010up (LTFU<\/jats:styled-content>) were assessed for people living with HIV<\/jats:styled-content> (PLHIV<\/jats:styled-content>) at various reference out\u2010patient clinics (expertise level II<\/jats:styled-content>) and hospitals (expertise level III<\/jats:styled-content>) in Mali.<\/jats:p><\/jats:sec>Methods<\/jats:title>HIV<\/jats:styled-content>\u20101\u2010positive adults starting antiretroviral therapy (ART<\/jats:styled-content>) in 2006\u20132013 were eligible for inclusion. Risk factors for LTFU<\/jats:styled-content>, defined as no visit in the 6 months preceding the last database update, were assessed with the Cox model, taking into account the competing risks of transfer and death. Potential risk factors at the start of ART<\/jats:styled-content> were demographic and socioeconomic variables, World Health Organization (WHO<\/jats:styled-content>) stage, CD<\/jats:styled-content>4 count, period of ART<\/jats:styled-content> initiation, type of ART<\/jats:styled-content>, region of care, expertise level and distance from home.<\/jats:p><\/jats:sec>Results<\/jats:title>We included 9821 PLHIV<\/jats:styled-content>, 33% of whom were male, starting ART<\/jats:styled-content> at nine out\u2010patient clinics and seven hospitals [five and two in the capital Bamako and four and five in the \u2018regions\u2019 (i.e. districts outside the capital), respectively] with a median (interquartile range<\/jats:styled-content>) CD<\/jats:styled-content>4 count of 153 (56\u2013270) cells\/\u03bcL. Five\u2010year cumulative incidences of LTFU<\/jats:styled-content>, transfer and death were 35.2, 9.7 and 6.7%, respectively. People followed at Bamako hospitals >\u00a05\u00a0km from home, at regional hospitals or at regional out\u2010patient clinics <\u00a05\u00a0km from home were at higher risk of LTFU<\/jats:styled-content> than people followed at Bamako out\u2010patient clinics, whereas people followed at regional out\u2010patient clinics 5\u201350\u00a0km away from home were at lower risk for LTFU<\/jats:styled-content>. Deaths were less frequent at hospitals, whether in Bamako or in the regions, than at Bamako out\u2010patient clinics, and more frequent at regional out\u2010patient clinics.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Expertise level and distance to care were associated with LTFU<\/jats:styled-content>. Stigmatization may play a role for PLHIV<\/jats:styled-content> living close to the centres in the regions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12668","type":"journal-article","created":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T03:38:32Z","timestamp":1538365112000},"page":"47-53","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Risk factors for loss to follow\u2010up, transfer or death among people living with HIV<\/scp> on their first antiretroviral therapy regimen in Mali"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5956-698X","authenticated-orcid":false,"given":"A","family":"Bald\u00e9","sequence":"first","affiliation":[{"name":"Pierre Louis Institute of Epidemiology and Public Health IPLESP Sorbonne Universit\u00e9 INSERM Paris 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Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IA","family":"Maiga","sequence":"additional","affiliation":[{"name":"D\u00e9partement sant\u00e9 Ensemble pour une Solidarit\u00e9 Th\u00e9rapeutique Hospitali\u00e8re en R\u00e9seau (ESTHER)\/Expertise France Bamako Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Costagliola","sequence":"additional","affiliation":[{"name":"Pierre Louis Institute of Epidemiology and Public Health IPLESP Sorbonne Universit\u00e9 INSERM Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7891-7594","authenticated-orcid":false,"given":"S","family":"Abgrall","sequence":"additional","affiliation":[{"name":"Pierre Louis Institute of Epidemiology and Public Health IPLESP Sorbonne Universit\u00e9 INSERM Paris France"},{"name":"Service de M\u00e9decine Interne AP\u2010HP H\u00f4pital Antoine B\u00e9cl\u00e8re INSERM Universit\u00e9 Paris Sud Universit\u00e9 Paris Saclay Clamart France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2010.02505.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833d45c5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000268"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040298"},{"key":"e_1_2_8_6_1","unstructured":"Cellule Sectorielle de Lutte contre le VIH\u2010Sida du Minist\u00e8re de la Sant\u00e9 et de l'Hygi\u00e8ne Publique (CSLS\/MSHP).Politique et protocoles de prise en charge antir\u00e9trovirale du VIH et du Sida 2013."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-016-0149-9"},{"key":"e_1_2_8_8_1","unstructured":"Cellule Sectorielle de Lutte contre le VIH\u2010Sida du Minist\u00e8re de la 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