Table 2. Univariate analyses of comprehensive retention in care among 13 331 HIV-positive patients enrolled in care at 63 facilities in the Eastern and Nyanza regions of Kenya, January 2014 to March 2016 .
| Variable | Total no. of patients | Patients retained in comprehensive care for 12 months,a no. (%) | RR (95% CI)b | |
|---|---|---|---|---|
| Yes | No | |||
| Total | 13 331 | 8 404 (63) | 4 927 (37) | N/A |
| Facility type | ||||
| Public primary | 5 856 | 3 780 (65) | 2 076 (35) | 1.09 (0.93–1.28) |
| Public secondary | 6 662 | 4 077 (61) | 2 585 (39) | Ref. |
| Private | 813 | 547 (67) | 266 (33) | 1.04 (0.79–1.37) |
| Facility location | ||||
| Urban | 650 | 424 (65) | 226 (35) | 1.08 (0.60–1.97) |
| Semi-urban | 6 824 | 4 456 (65) | 2 368 (35) | 1.08 (0.93–1.26) |
| Rural | 5 857 | 3 524 (60) | 2 333 (40) | Ref. |
| Region | ||||
| Eastern | 3 636 | 2 491 (69) | 1 145 (31) | 1.12 (1.09–1.15) |
| Nyanza | 9 695 | 5 913 (61) | 3 782 (39) | Ref. |
| CD4+ cell testing | ||||
| Specimen collected & analysed at facility | 5 661 | 3 581 (63) | 2 080 (37) | 0.98 (0.83–1.16) |
| Specimen collected at facility, analysed elsewhere | 7 670 | 4 823 (63) | 2 847 (37) | Ref. |
| Community ART adherence group | ||||
| Yes | 6 871 | 4 432 (65) | 2 439 (35) | 1.02 (0.88–1.18) |
| No | 6 460 | 3 972 (61) | 2 488 (39) | Ref. |
| Financial incentives for adherence | ||||
| Yes | 1 346 | 901 (67) | 445 (33) | 1.09 (0.83–1.44) |
| No | 11 985 | 7 503 (63) | 4 482 (37) | Ref. |
| Adherence support: group counselling | ||||
| Yes | 13 038 | 8 218 (63) | 4 820 (37) | 1.15 (0.74–1.78) |
| No | 293 | 186 (63) | 107 (37) | Ref. |
| Assessment of ART eligibility by nurse | ||||
| Yes | 11 996 | 7 829 (65) | 4 167 (35) | 1.27 (1.00–1.61) |
| No | 1 335 | 575 (43) | 760 (57) | Ref. |
| Initiation of ART by nurse | ||||
| Yes | 11 092 | 7 318 (66) | 3 774 (34) | 1.30 (1.06–1.60) |
| No | 2 239 | 1 086 (49) | 1 153 (51) | Ref. |
| Follow-up of ART by nurse | ||||
| Yes | 10 738 | 7 116 (66) | 3 622 (34) | 1.29 (1.06–1.58) |
| No | 2 593 | 1 288 (50) | 1 305 (50) | Ref. |
| Physician at HIV clinic | ||||
| Yes | 1 436 | 649 (45) | 787 (55) | 0.75 (0.57–0.98) |
| No | 11 895 | 7 755 (65) | 4 140 (35) | Ref. |
| Outreach workers at HIV clinic | ||||
| Yes | 6 496 | 4 122 (63) | 2 374 (37) | 0.96 (0.83–1.12) |
| No | 6 835 | 4 282 (63) | 2 553 (37) | Ref. |
| Patient volume, no. of new enrollees per year | ||||
| < 150 | 2 358 | 1 156 (45) | 1 420 (55) | 0.78 (0.65–0.93) |
| 150–300 | 6 283 | 2 489 (64) | 1 383 (36) | 0.95 (0.80–1.12) |
| > 300 | 4 690 | 4 759 (69) | 2 124 (31) | Ref. |
| Age, years | ||||
| < 2 | 415 | 251 (60) | 164 (40) | 0.95 (0.88–1.03) |
| 2–14 | 836 | 559 (67) | 277 (33) | 1.08 (1.02–1.14) |
| 15–24 | 2 652 | 1 689 (64) | 963 (36) | 1.01 (0.97–1.05) |
| 25–39 | 6 530 | 4 108 (63) | 2 422 (37) | Ref. |
| 40–49 | 1 727 | 1 102 (64) | 625 (36) | 0.94 (0.89–0.99) |
| 50+ | 1 171 | 695 (59) | 476 (41) | 0.99 (0.96–1.03) |
| Sex | ||||
| Male | 4 728 | 2 940 (62) | 1 788 (38) | 0.97 (0.95–1.00) |
| Female | 8 603 | 5 464 (64) | 3 139 (36) | Ref. |
| Immune status at enrolment | ||||
| CD4+ cell count > 200 cells/µL, or WHO stage 1 or 2 | 7 847 | 5 674 (72) | 2 173 (28) | Ref. |
| CD4+ cell count ≤ 200 cells/µL, or WHO stage 3 or 4 | 3 612 | 1927 (53) | 1 685 (47) | 0.75 (0.73–0.78) |
| Unrecorded | 1 872 | 803 (43) | 1 069 (57) | 0.67 (0.64–0.71) |
ART: antiretroviral therapy; CD4+ cell: CD4+ T lymphocyte; CI: confidence interval; HIV: human immunodeficiency virus; N/A: not applicable; Ref.: reference category; RR: relative risk; WHO: World Health Organization.
a Patients achieved 12 months of retention in comprehensive HIV care if they were: assessed for ART eligibility (CD4+ cell count or WHO stage); initiated on ART, if eligible; and retained on ART for 12 months after enrolment, or retained in care for 12 months if ART ineligible.
b Relative risks of achieving 12-month retention in care were calculated using generalized linear mixed log-binomial relative risk regression with random intercepts to account for within-clinic correlation.
Note: Data were collected for patients enrolling in HIV care between 1 January 2014 and 31 March 2015 and followed up to 31 March 2016.