TITLE:
Loss to Follow-Up among a Group of Patients with HIV and Severe Mental Illness in South Africa
AUTHORS:
Todd Wagner, Jennifer Furin, Barbara Gripshover, Yasmien Jeenah, Greg Jonsson
KEYWORDS:
HIV; Mental Illness; Loss of Follow-Up; South Africa
JOURNAL NAME:
World Journal of AIDS,
Vol.4 No.1,
March
12,
2014
ABSTRACT: Background: Persons with
HIV and severe mental illness face numerous barriers in antiretroviral
treatment adherence. More information is needed on reasons for loss of follow-up
in this population. Methods: A retrospective analysis was conducted on adult
HIV patients with a history of mental illness enrolled at an urban HIV clinic
in Johannesburg, South Africa who discontinued care. Results: 24.8% of adult
patients in the clinic discontinued follow-up during the study period. Of those
discontinuing follow-up, 48 were successfully traced by home visits. Among this
group, 21 (43.8%) were not engaged in care, 12 (25.0%) had transferred care, 9
(18.8%) were deceased, 3 (6.2%) had relocated, and 3 (6.2%) were missing.
Transportation costs and distance, conflicts with work/school schedule, and
confusion regarding when to return were the most frequently cited reasons for
discontinuing follow-up. Conclusions: Although almost 25% of patients were lost
to follow up, overall rates of retention in care for these patients were
similar to those seen in other HIV-infected populations and higher than those
seen among patients with psychiatric disease. Tracing patients through home
visits proved to be an effective means to confirm the magnitude of patients
lost to follow up, ascertain their outcomes, and elucidate the reasons for
discontinuing care.