High rates of unplanned interruptions from XXXX care early after antiretroviral therapy initiation in Nigeria.

@entity1 @entity404 @entity645 @entity12623
BACKGROUND: Unplanned care interruption (UCI) challenges effective @entity645 treatment. We determined the frequency and risk factors for UCI in Nigeria. METHODS: We conducted a retrospective-cohort study of adults initiating antiretroviral therapy (ART) between January 2009 and December 2011. At censor, @entity1 were defined as in care, UCI, or inactive. Associations between baseline factors and UCI rates were quantified using Poisson regression. RESULTS: Among 2,496 @entity1 , 44 % remained in care, 35 % had >= 1 UCI, and 21 % became inactive. UCI rates were higher in the first year on ART (39/100PY), than the second (19/100PY), third (16/100PY), and fourth (14/100PY) years (p   <   0.001). In multivariate analysis, baseline @entity404   >   350/uL ( @entity12623 3.21, p   <   0.0001), being a student ( @entity12623 1.95, p   <   0.0001), and less education ( @entity12623 1.58, p   =   0.001) increased risk for UCI. Fifty-five percent of @entity1 with UCI and viral load data had @entity645 viral load   >   1,000 copies/ml upon return to care. DISCUSSION: UCI were observed in over one-third of @entity1 treated, and were most common in the first year on ART. High baseline @entity404 count at ART initiation was the greatest predictor of subsequent UCI. CONCLUSIONS: Interventions focused on the first year on ART are needed to improve continuity of @entity645 care.
