ART Attrition across Health Facilities Implementing Option B+ in Haiti

Area of Science:

• Public Health
• HIV/AIDS Research
• Health Services Management

Background:

• Option B+ strategy is vital for preventing mother-to-child HIV transmission in Haiti.
• Understanding attrition factors is key to improving Option B+ implementation.
• High attrition rates can undermine the effectiveness of HIV/AIDS interventions.

Purpose of the Study:

• To describe antiretroviral therapy (ART) retention variability across health facilities.
• To assess ART retention differences between Option B+ clients and other ART patients.
• To identify factors associated with high attrition among Option B+ clients in Haiti.

Main Methods:

• Retrospective cohort study design.
• Analysis of ART retention data from 45 health facilities in Haiti.
• Comparison of attrition rates between Option B+ clients and other ART patients.

Main Results:

• Attrition varied significantly (9%-81%) across facilities.
• Large facilities showed a 38% higher risk of attrition (RR: 1.38).
• Private facilities had 18% less attrition risk (RR: 0.82); West and South regions had lower attrition.

Conclusions:

• Large, public facilities and northern locations are risk factors for high attrition.
• Option B+ implementation requires reevaluation to reduce attrition.
• Effective elimination of mother-to-child HIV transmission depends on addressing attrition.