{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:51:46Z","timestamp":1787014306516,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","award":["1U2GGH001039"],"award-info":[{"award-number":["1U2GGH001039"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The introduction of universal test and treat (UTT) strategy has demonstrated a reduction in attrition in some low\u2010resource settings. UTT was introduced in Ethiopia in 2016. However, there is a paucity of information regarding the magnitude and predictors of attrition from HIV treatment in Ethiopia. This study aims to assess the incidence and predictors of attrition from HIV treatment among adults living with HIV (PLHIV) in high\u2010caseload facilities following the implementation of universal test and treat strategy in Ethiopia from March 2019 to June 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort of individuals in HIV care from 39 high\u2010caseload facilities in Oromia, Amhara, Tigray, Addis Ababa and Dire Dawa regions of Ethiopia was conducted for 12\u2009months. Participants were adults aged 15\u2009year and older who were first testers recruited for 3 months from March to June 2019. Subsequent follow\u2010up was for 12\u2009months, with data collected on sociodemographic and clinical conditions at baseline, 6 and 12\u2009months and attrition at 6 and 12\u2009months. We defined attrition as discontinuation from follow\u2010up care due to loss to follow\u2010up, dropout or death. Data were collected using Open Data Kit at field level and aggregated centrally. Kaplan\u2013Meier survival analysis was employed to assess survival probability to the time of attrition from treatment. The Cox proportional hazards regression model was used to measure association of baseline predictor variables with the proportion of antiretroviral therapy (ART) patients retained in ART during the follow up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall incidence rate for attrition from HIV treatment among the study participants during 12\u2009months of follow\u2010up was 5.02 cases per 1000 person\u2010weeks [95% confidence interval (CI): 4.44\u20135.68 per 1000 person\u2010weeks]. Study participants from health facilities in Oromia and Addis Ababa\/Dire Dawa had 68% and 51% higher risk of attrition from HIV treatment compared with participants from the Amhara region, respectively [adjusted hazard ratio (AHR) =\u20091.68, 95% CI: 1.22\u20132.32 and AHR\u2009=\u20091.51, 95% CI: 1.05\u20132.17, respectively]. Participants who did not have a child had a 44% higher risk of attrition compared with those who had a child (AHR\u2009=\u20091.44, 95% CI: 1.12\u20131.85). Individuals who did not own mobile phone had a 37% higher risk of attrition than those who owned a mobile phone (AHR\u2009=\u20091.37, 95% CI: 1.02\u20131.83). Ambulatory\/bedridden functional status at the time of diagnosis had a 44% higher risk of attrition compared with participants with a working functional status (AHR\u2009=\u20091.44, 95% CI: 1.08\u20131.92) at any time during the follow\u2010up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The overall incidence of attrition among people living with HIV enrolled into HIV treatment was not as high as what was reported by other studies. Independent predictors of attrition were administrative regions in Ethiopia where health facilities are located, not having a child, not owning a mobile phone and being ambulatory\/bedridden functional status at the time of diagnosis. Concerted efforts should be taken to reduce the magnitude of attrition from HIV treatment and address its drivers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.13691","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T23:05:21Z","timestamp":1722985521000},"page":"1227-1239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Incidence and predictors of attrition from\n                    <scp>HIV<\/scp>\n                    treatment among adults living with\n                    <scp>HIV<\/scp>\n                    in high\u2010caseload facilities following implementation of universal test and treat strategy in Ethiopia: A prospective cohort study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5972-0457","authenticated-orcid":false,"given":"Alemayehu","family":"Bekele","sequence":"first","affiliation":[{"name":"Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa) College of Health Sciences, Addis Ababa University  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismael","family":"Ahmed","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fana","family":"Tefera","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3468-8785","authenticated-orcid":false,"given":"Jemal Ayalew","family":"Yimam","sequence":"additional","affiliation":[{"name":"Wollo University, Department of Statistics College of Natural Science  Dessie Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fasil Tessema","family":"Woldeselassie","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getinet","family":"Abera","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelaludin","family":"Ahmed","sequence":"additional","affiliation":[{"name":"International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University's Mailman School of Public Health  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemayehu","family":"Mekonnen","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashenafi","family":"Haile","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fikerte","family":"Yohannes","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirtie","family":"Getachew","sequence":"additional","affiliation":[{"name":"Ministry of Health of Ethiopia  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saro","family":"Abdella","sequence":"additional","affiliation":[{"name":"Ethiopian Public Health Institute  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minesh","family":"Shah","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention (CDC)  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"The path that ends AIDS: UNAIDS global AIDS update 2023.:Joint United Nations Programme on HIV\/AIDS.2023. Licence: CC BY\u2010NC\u2010SA 3.0 IGO."},{"key":"e_1_2_11_3_1","unstructured":"UNAIDS. Global\u2010HIV\/Aids statistics. Vol.3 Factsheet on HIV epidemiological Estimate.2023."},{"key":"e_1_2_11_4_1","unstructured":"WHO. Global HIV Programme. WHO HIV policy adoption and implementation status in countries. 2022;2021."},{"key":"e_1_2_11_5_1","unstructured":"World Health Organization. Guideline on when to start antiretroviral therapy and on pre\u2010exposure prophylaxis for HIV.2015 1\u201376."},{"key":"e_1_2_11_6_1","unstructured":"UNAIDS. Global HIV Statistics. Fact Sheet 2021.2021 1\u20133."},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25652"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0268226"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12981\u2010020\u201000274\u20103"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000259"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2022.e11527"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0263663"},{"key":"e_1_2_11_13_1","first-page":"1","volume-title":"National Consolidated Guidelines for comprehensive Hiv prevention, care and","author":"Federal Ministry of Health Ethiopia","year":"2018"},{"key":"e_1_2_11_14_1","first-page":"445","article-title":"Attrition and its predictors among adults receiving first\u2010line antiretroviral therapy in woldia town public health facilities, Northeast Ethiopia: a retrospective cohort study","volume":"13","author":"Dejen D","year":"2021","journal-title":"HIV AIDS"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1814-2"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002530"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1596\/978-1-4648-0346-8_ch9"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0661-3"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.2196\/12652"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05168-3"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006927"},{"key":"e_1_2_11_22_1","first-page":"1","volume-title":"UNAIDS data 2023","author":"The Joint United Nations Programme on HIV\/AIDS","year":"2023"},{"key":"e_1_2_11_23_1","unstructured":"PEPFAR. Ethiopia Country operational plan (COP) 2015 strategic direction summary.2015;1\u201351. Available from:https:\/\/www.pepfar.gov\/documents\/organization\/250287.pdf."},{"key":"e_1_2_11_24_1","unstructured":"MohE. New Ethiopia POCKET\u2010GUIDE\u2010compressed\u20101.pdf.2022. p.1\u201328."},{"key":"e_1_2_11_25_1","unstructured":"A.Bekele \u2009I.Ahmed \u2009F.Tefera \u2009J. A.Yimam \u2009F. T.Woldeselassie \u2009G.Abera \u2009J.Ahmed \u2009A.Mekonnen \u2009A.Haile \u2009F.Yohannes \u2009M.Getachew \u2009S.Abdella \u2009M.Shah. et al. Assessment of patients\u2019outcomes along the HIV continuum study_full report_March 16_2023.2023."},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-1075.53513"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20101\u20104612\u20100103\u20108_18"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2021-001135"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000006"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0222309"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T19:55:17Z","timestamp":1731354917000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,6]]},"references-count":29,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/hiv.13691"],"URL":"https:\/\/doi.org\/10.1111\/hiv.13691","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,6]]},"assertion":[{"value":"2024-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}