{"doi":"10.1093/cid/ciab428","title":"Tracing People Living With Human Immunodeficiency Virus Who Are Lost to Follow-up at Antiretroviral Therapy Programs in Southern Africa: A Sampling-Based Cohort Study in 6 Countries","abstract":"BACKGROUND: Attrition threatens the success of antiretroviral therapy (ART). In this cohort study, we examined outcomes of people living with human immunodeficiency virus (PLHIV) who were lost to follow-up (LTFU) during 2014-2017 at ART programs in Southern Africa. METHODS: We confirmed LTFU (missed appointment for ≥60 or ≥90 days, according to local guidelines) by checking medical records and used a standardized protocol to trace a weighted random sample of PLHIV who were LTFU in 8 ART programs in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, 2017-2019. We ascertained vital status and identified predictors of mortality using logistic regression, adjusted for sex, age, time on ART, time since LTFU, travel time, and urban or rural setting. RESULTS: Among 3256 PLHIV, 385 (12%) were wrongly categorized as LTFU and 577 (17%) had missing contact details. We traced 2294 PLHIV (71%) by phone calls, home visits, or both: 768 (34% of 2294) were alive and in care, including 385 (17%) silent transfers to another clinic; 528 (23%) were alive without care or unknown care; 252 (11%) had died. Overall, the status of 1323 (41% of 3256) PLHIV remained unknown. Mortality was higher in men than women, higher in children than in young people or adults, and higher in PLHIV who had been on ART <1 year or LTFU ≥1 year and those living farther from the clinic or in rural areas. Results were heterogeneous across sites. CONCLUSIONS: Our study highlights the urgent need for better medical record systems at HIV clinics and rapid tracing of PLHIV who are LTFU.","journal":"Clinical Infectious Diseases","year":2021,"id":188395,"datarank":0.4335557636844247,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.0,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7651,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":563740,"name":"Benedikt Christ","orcid":"0000-0001-8478-9915","position":1,"is_corresponding":false},{"id":497681,"name":"Nanina Anderegg","orcid":"0000-0002-8238-8832","position":2,"is_corresponding":false},{"id":277848,"name":"Frédérique Chammartin","orcid":"0000-0001-8959-2724","position":3,"is_corresponding":false},{"id":559190,"name":"Josephine Muhairwe","orcid":"0000-0002-1314-4543","position":4,"is_corresponding":false},{"id":498487,"name":"Laura Jefferys","orcid":null,"position":5,"is_corresponding":false},{"id":497682,"name":"Jonas Hector","orcid":"0000-0003-3643-7952","position":6,"is_corresponding":false},{"id":559188,"name":"Janneke van Dijk","orcid":"0000-0003-2970-9286","position":7,"is_corresponding":false},{"id":393581,"name":"Michael J. Vinikoor","orcid":"0000-0002-3862-7795","position":8,"is_corresponding":false},{"id":292868,"name":"Monique van Lettow","orcid":"0000-0002-0679-285X","position":9,"is_corresponding":false},{"id":361253,"name":"Cleophas Chimbetete","orcid":"0000-0002-3756-3523","position":10,"is_corresponding":false},{"id":361250,"name":"Sam Phiri","orcid":"0000-0002-9372-212X","position":11,"is_corresponding":false},{"id":706366,"name":"Dorina Onoya","orcid":"0000-0002-2664-7342","position":12,"is_corresponding":false},{"id":87357,"name":"Matthew P. Fox","orcid":"0000-0001-9887-0634","position":13,"is_corresponding":false},{"id":4469,"name":"Matthias Egger","orcid":"0000-0001-7462-5132","position":14,"is_corresponding":false},{"id":424028,"name":"Marie Ballif","orcid":"0000-0003-3133-3011","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:49:10.350554Z","pmid":"33993219","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}