{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:08:47Z","timestamp":1777853327696,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2006,9,1]],"date-time":"2006-09-01T00:00:00Z","timestamp":1157068800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of the International Association of Physicians in AIDS Care"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:p>\n                    Background:In October 2001, a paying antiretroviral therapy service was introduced at a Central Hospital in Malawi using stavudine 40 mg\/lamivudine 150 mg\/nevirapine 200 mg (triomune). The objective of this study was to determine characteristics of patients seeking antiretroviral therapy, retention in care, clinical outcomes, and outlines for program improvement. Methods: Retrospectively, all patients seeking anti-retroviral therapy initiation (October 2001 to October 2002; follow-up through April 2003) were evaluated for laboratory results, retention in care, toxicity, and mortality. Hazard ratios for factors associated with dropout were determined. Results: Of 757 patients seeking evaluation, 625 began treatment. Documented mortality rate was 61 of 757. Total dropout rate was 50%. Factors associated with dropout include CD4 count &lt;50 cells\/mm\n                    <jats:sub>3<\/jats:sub>\n                    and Kaposi's sarcoma. Twenty-seven of 625 patients discontinued therapy for toxicity. Conclusions: The paying antiretroviral therapy program showed an unacceptable dropout rate associated with advanced baseline disease. Severe toxicity rate was low. Areas for improved program performance include lower cost, wide and earlier access to antiretroviral therapy, and targeted retention strategies.\n                  <\/jats:p>","DOI":"10.1177\/1545109706288722","type":"journal-article","created":{"date-parts":[[2006,8,23]],"date-time":"2006-08-23T13:03:06Z","timestamp":1156338186000},"page":"103-108","source":"Crossref","is-referenced-by-count":14,"title":["Lessons Learned From a Paying Antiretroviral Therapy Service in the Public Health Sector at Kamuzu Central Hospital, Malawi"],"prefix":"10.1177","volume":"5","author":[{"given":"Mina C.","family":"Hosseinipour","sequence":"first","affiliation":[{"name":"University of North Carolina Project, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian H.","family":"Neuhann","sequence":"additional","affiliation":[{"name":"Lighthouse Trust Clinic, Lilongwe, Malawi; Department of Tropical Hygiene and Public Health, University Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecelia C.","family":"Kanyama","sequence":"additional","affiliation":[{"name":"University of North Carolina Project, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan C.","family":"Namarika","sequence":"additional","affiliation":[{"name":"Kamuzu Central Hospital, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Weigel","sequence":"additional","affiliation":[{"name":"Lighthouse Trust Clinic, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Miller","sequence":"additional","affiliation":[{"name":"University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam J. P.","family":"Phiri","sequence":"additional","affiliation":[{"name":"Lighthouse Trust Clinic, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2006,9,1]]},"reference":[{"key":"atypb1","volume-title":"Joint United Nations Programme on HIV\/AIDS Web site","author":"AIDS Epidemic Update","year":"2002"},{"key":"atypb2","volume-title":"Providing Wider Access to HIV-Related Drugs in Developing Countries. Pilot Phase. Report of the Meeting on the Evaluation of the Initiative (20-31 May 2000).","author":"UNAIDS HIV Drug Access Initiative","year":"2000"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200309050-00023"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16586-0"},{"key":"atypb5","volume-title":"World Development Indicators Database: Malawi Data Profile [database online]","year":"2003"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1086\/431199"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.331.7519.742"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16119-9"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15997-7"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.12.930"},{"key":"atypb11","volume-title":"Stavudine [prescribing information]"},{"key":"atypb12","volume-title":"11th Conference on Retroviruses and Opportunistic Infections","author":"Hosseinipour M"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1086\/498030"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200404090-00006"},{"key":"atypb15","volume-title":"Treatment of AIDS: The 2-Year Plan to Scale Up Antiretroviral Therapy in Malawi","author":"Malawi Ministry of Health","year":"2004"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7475.1163"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0020276"}],"container-title":["Journal of the International Association of Physicians in AIDS Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1545109706288722","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1545109706288722","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:51:18Z","timestamp":1777503078000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1545109706288722"}},"subtitle":["1-Year Experience"],"short-title":[],"issued":{"date-parts":[[2006,9]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2006,9]]}},"alternative-id":["10.1177\/1545109706288722"],"URL":"https:\/\/doi.org\/10.1177\/1545109706288722","relation":{},"ISSN":["1545-1097"],"issn-type":[{"value":"1545-1097","type":"print"}],"subject":[],"published":{"date-parts":[[2006,9]]}}}