{"doi":"10.31219/osf.io/mkhr3","title":"Tracing people living with HIV who are lost to follow-up at antiretroviral therapy programs in Southern Africa: A sampling-based study in six countries","abstract":"Background: Attrition threatens the success of antiretroviral therapy (ART). In this cohort study, we examined outcomes of people living with HIV (PLHIV) lost to follow-up (LTFU) 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 eight 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 3,256 PLHIV, 385 (12%) were wrongly categorized as LTFU and 577 (17%) had missing contact details. We traced 2,294 PLHIV (71%) by phone calls, home visits or both: 768 (34% of 2,294) 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 1,323 (41% of 3,256) PLHIV remained unknown. Mortality was higher in men than women, higher in children than in young people or adults, higher in PLHIV who had been on ART <1 year or lost >1 year, living further 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":"OSF Preprints (OSF Preprints)","year":2020,"id":134717,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8573,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":424028,"name":"Marie Ballif","orcid":"0000-0003-3133-3011","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":590706,"name":"Janneke H. van Dijk","orcid":null,"position":6,"is_corresponding":false},{"id":393581,"name":"Michael J. Vinikoor","orcid":"0000-0002-3862-7795","position":7,"is_corresponding":false},{"id":292868,"name":"Monique van Lettow","orcid":"0000-0002-0679-285X","position":8,"is_corresponding":false},{"id":361253,"name":"Cleophas Chimbetete","orcid":"0000-0002-3756-3523","position":9,"is_corresponding":false},{"id":361250,"name":"Sam Phiri","orcid":"0000-0002-9372-212X","position":10,"is_corresponding":false},{"id":4469,"name":"Matthias Egger","orcid":"0000-0001-7462-5132","position":11,"is_corresponding":false},{"id":563740,"name":"Benedikt Christ","orcid":"0000-0001-8478-9915","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T23:16:27.963294Z","pmid":null,"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":[]}