Table 3.
Predictors of ART initiation within 30 days and six‐month retention in care among patients enrolling in care in 10 Rwandan health centres during the Treat All period
| ART initiation within 30 days (N=1082) | Six‐month retention in care (N=559) | |||
|---|---|---|---|---|
| RR (95% CI) | aRR (95% CI) | RR (95% CI) | aRR (95% CI) | |
| Patient characteristics | ||||
| Female (vs. male) | 1.00 (0.96, 1.04) | 1.00 (0.96, 1.03) | 1.00 (0.97, 1.04) | 1.03 (0.99, 1.07) |
| Aged 15 to 24 years (vs. >24 years) | 0.94 (0.88, 0.99)* | 0.93 (0.87, 1.00)* | 0.89 (0.82, 0.97)* | 0.89 (0.82, 0.98)* |
| Referral source, n (%) | ||||
| Maternal/prenatal health versus VCT | 1.07 (1.02, 1.14)** | 1.07 (1.02, 1.13)* | 1.01 (0.95, 1.08) | 1.00 (0.94, 1.07) |
| Othera versus VCT | 1.03 (0.99, 1.07) | 1.04 (1.01, 1.08)* | 1.00 (0.86, 1.17) | 1.01 (0.88, 1.16) |
| BMI <18.5 kg/m2 (vs. ≥18.5), n (%) | 0.96 (0.89, 1.04) | 0.97 (0.90, 1.05) | 1.00 (0.92, 1.09) | 1.01 (0.93, 1.09) |
| WHO HIV stage | ||||
| Stage III‐IV versus Stage I‐II | 0.95 (0.88, 1.02) | 0.97 (0.88, 1.07) | 1.00 (0.94, 1.07) | 0.99 (0.91, 1.07) |
| Missing versus Stage I | 0.88 (0.73, 1.06) | 0.95 (0.83, 1.09) | 0.89 (0.75, 1.05) | 0.87 (0.74, 1.02) |
| CD4 cell count | ||||
| <200 versus ≥500 cells/mm3 | 0.99 (0.92, 1.06) | 0.99 (0.91, 1.07) | 1.01 (0.97, 1.06) | 1.01 (0.97, 1.06) |
| 200 to 349 versus ≥500 cells/mm3 | 1.04 (0.97, 1.11) | 1.04 (0.97, 1.11) | 0.96 (0.79, 1.15) | 0.96 (0.81, 1.13) |
| 350 to 499 versus ≥500 cells/mm3 | 1.03 (0.97, 1.09) | 1.03 (0.97, 1.10) | 1.09 (1.01, 1.16)* | 1.08 (1.01, 1.15)* |
| Missing versus ≥500 cells/mm3 | 0.92 (0.82, 1.04) | 0.94 (0.83, 1.05) | 0.90 (0.80, 1.02) | 0.92 (0.83, 1.01) |
| ART initiation <30 days (vs. not initiated in <30 days) | ‐ | ‐ | 1.18 (1.07, 1.29)** | 1.15 (1.07, 1.24)** |
| Health centre characteristics | ||||
| Peri‐urban versus urban | 0.88 (0.75, 1.03) | 0.91 (0.78, 1.05) | 0.91 (0.83, 1.02) | 0.94 (0.85, 1.05) |
| ≥2000 HIV patients in care (vs. <2000) | 1.08 (0.97, 1.21) | 1.07 (0.97, 1.19) | 1.00 (0.89, 1.12) | 0.99 (0.89, 1.10) |
| Age‐differentiated clinic (vs. all‐ages clinic) | 1.04 (0.91, 1.18) | 1.05 (0.93, 1.18) | 0.93 (0.84, 1.04) | 0.93 (0.84, 1.03) |
| Physician available some/all of the time (vs. not) | 0.97 (0.86, 1.10) | 0.98 (0.86, 1.11) | 1.06 (0.95, 1.17) | 1.06 (0.95, 1.18) |
| Incentives for early enrolment in care (vs. not) | 0.95 (0.84, 1.08) | 0.96 (0.86, 1.09) | 1.08 (0.98, 1.19) | 1.08 (1.01, 1.15)* |
| 4 pre‐ART counselling sessions (vs. < 4) | 0.94 (0.83, 1.07) | 0.95 (0.84, 1.07) | 1.04 (0.93, 1.16) | 1.04 (0.94, 1.15) |
| Types of ART adherence support routinely available (vs. not available) | ||||
| Referral to mental health counselling | ‐ | ‐ | 1.00 (0.90, 1.12) | 0.98 (0.91, 1.06) |
| Referral to peer support | ‐ | ‐ | 0.96 (0.86, 1.06) | 0.94 (0.86, 1.03) |
| Routine review of medication pickup | ‐ | ‐ | 0.97 (0.87, 1.08) | 0.96 (0.88, 1.05) |
ART, antiretroviral therapy; RR, rate ratio; CI, confidence interval; VCT, voluntary counselling and testing; BMI, body mass index; WHO, World Health Organization.
a
Other includes tuberculosis programme, referral from primary care, referral from inpatient hospitalization, sex worker outreach, mobile VCT.
*
p < 0.05; **p < 0.01.