TABLE 5.
Univariate and multivariate analysis of the predictors of attrition among 23,686 patients infected with HIV and having initiated antiretroviral therapy between September 2007 and April 2020 in 9 large-volume care sites (Conakry and Nzérékoré, Guinea. 2021).
| Characteristics | Total | Person year | Attrition$ | Attrition (%) | Attrition (1,000 person-years) | Univariate analysis | Multivariate analysis | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Crude HR | p-value | 95% CI | aHR | p-value | 95% CI | ||||||
| Total | 23,686 | 73,427 | 8,337 | 35.2 | 11.4 | ||||||
| Site area | |||||||||||
| Conakry | 20,787 | 64,440 | 7,426 | 35.7 | 11.5 | 1.10 | 0.008 | (1.075–1.186) | NS | NS | |
| Interior | 2,899 | 8,987 | 911 | 31.4 | 10.1 | 1 | |||||
| Year of initiation of ART | |||||||||||
| 2007–2012 | 4,684 | 14,520 | 1,550 | 33.1 | 10.67 | 1.12 | 0.070 | (0.981–1.321) | 1.09 | 0.065 | (0.764–1.26) |
| 2012–2015 | 4,023 | 11,471 | 1,835 | 45.6 | 15.99 | 2.78 | <0.001 | (2.096–3.564) | 2.81 | <0.001 | (2.172–3.643) |
| 2015–2017 | 5,319 | 16,489 | 1,809 | 34.0 | 10.97 | 1.23 | <0.001 | (1.120–1.961) | 1.27 | <0.001 | (1.131–2.102) |
| 2017–2020 | 9,660 | 29,946 | 3,002 | 31.1 | 10.02 | 1 | 1 | ||||
| Legal status of the site | |||||||||||
| Private | 2,899 | 8,987 | 911 | 31.4 | 10.1 | 1 | |||||
| Public | 20,787 | 64,440 | 7,426 | 35.7 | 11.5 | 1.12 | 0.008 | (1.027–1.186) | NS | NS | |
| Site level in the pyramid of care | |||||||||||
| Level 3 | 2,899 | 8,987 | 911 | 31.4 | 10.1 | 1 | |||||
| Level 2 | 8,456 | 26,214 | 3,233 | 38.2 | 12.3 | 1.19 | <0.001 | (1.080–1.281) | |||
| Level 1 | 12,331 | 38,226 | 4,193 | 34.0 | 10.9 | 1.06 | 0.236 | (0.875–1.132) | NS | NS | |
| Sex | |||||||||||
| Women | 16,345 | 50,670 | 5,463 | 33.4 | 10.8 | 1 | |||||
| Man | 7,341 | 22,757 | 2,874 | 39.1 | 12.6 | 1.25 | <0.001 | (1.186–1.301) | NS | NS | |
| Age group | |||||||||||
| Adults (15 years and older) | 23,371 | 72,450 | 8,281 | 35.4 | 11.4 | 2.525 | <0.001 | (1.941–3.284) | 1.50 | 0.003 | (1.102–2.002) |
| Children (under 15) | 315 | 977 | 56 | 17.8 | 5.7 | 1 | 1 | ||||
| Marital status | |||||||||||
| Married | 18,072 | 56,023 | 6,320 | 35.0 | 11.3 | 1 | 1 | ||||
| Not married | 5,606 | 17,379 | 2,016 | 36.0 | 11.6 | 1.09 | 0.007 | (1.008–1.122) | 1.182 | 0.004 | (1.013–1.347) |
| Employment status | |||||||||||
| Employee | 8,912 | 27,627 | 3,163 | 35.5 | 11.5 | 1.01 | 0.694 | (0.965–1.055) | |||
| Unemployed | 14,764 | 45,768 | 5,170 | 35.0 | 11.3 | 1 | |||||
| Type of HIV | |||||||||||
| HIV type 1 | 23,534 | 72,955 | 8,285 | 35.2 | 11.4 | 0.906 | 0.514 | (0.681–1.231) | NS | NS | |
| Other types (Type 2 or Type 1 + 2) | 132 | 409 | 46 | 34.8 | 11.2 | 1 | |||||
| Category of CD4 count in cells/μL | |||||||||||
| >350 | 7,703 | 23,879 | 642 | 8.3 | 2.7 | 1 | 1 | ||||
| 200–350 | 7,766 | 24,075 | 928 | 11.9 | 3.9 | 1.27 | <0.001 | (1.133–1.384) | 0.37 | <0.001 | (0.018–0.517) |
| 100–200 | 4,168 | 12,921 | 3,638 | 87.3 | 28.2 | 16.51 | <0.001 | (15.133–17.806) | 5.07 | <0.001 | (4.564–5.804) |
| <100 | 4,004 | 12,412 | 3,124 | 78.0 | 25.2 | 14.05 | <0.001 | (12.824–15.452) | 5.92 | <0.001 | (5.091–6.543) |
| WHO Stage of HIV infection | |||||||||||
| Early stage (I and II) | 12,381 | 38,381 | 1,759 | 14.2 | 4.6 | 1 | 1 | ||||
| Advanced stage (III and IV) | 11,305 | 35,046 | 6,578 | 58.2 | 18.8 | 4.85 | <0.001 | (4.701–5.286) | 3.66 | <0.001 | (3.045–3.975) |
| ART regimens | |||||||||||
| TDF + 3TC + EFV | 18,855 | 58,451 | 6,451 | 34.2 | 11.0 | 1.21 | <0.001 | (1.052–1.762) | NS | NS | |
| AZT + 3TC + NVP | 2,284 | 7,080 | 1,195 | 52.3 | 16.9 | 1.18 | <0.001 | (1.087–2.123) | |||
| Other ART regimes of first line | 2,547 | 7,896 | 691 | 27.1 | 8.8 | 1 | |||||
$ means number of people in attrition.