1 research outputs found
Discordant retention of HIV-infected mothers and children: Evidence for a family-based approach from Southern Mozambique
It is often assumed that children and their caregivers
either stay in care together or discontinue together, but data
is lacking on caregiver-child retention concordance. We sought
to describe the pattern of care among a cohort of human
immunodeficiency virus (HIV) infected children and mothers
enrolled in care at the Manhi\xC3\xA7a District Hospital
(MDH).This was a retrospective review of routine HIV clinical
data collected under a larger prospective HIV cohort study at
MDH. Children enrolling HIV care from January 2013 to November
2016 were identified and matched to their mother's HIV clinical
data. Retention in care for mothers and children was assessed at
24 months after the child's enrolment. Multinomial logistic
regression was performed to evaluate variables associated with
retention discordance.For the 351 mother-child pairs included in
the study, only 39% of mothers had concordant care status at
baseline (23% already active in care, 16% initiated care
concurrently with their children). At 24-months follow up, a
total of 108 (31%) mother-child pairs were concordantly retained
in care, 88 (26%) pairs were concordantly lost to follow up
(LTFU), and 149 (43%) had discordant retention. Pairs with
concurrent registration had a higher probability of being
concordantly retained in care. Children who presented with
advanced clinical or immunological stage had increased
probability of being concordantly LTFU.High rates of LTFU as
well as high proportions of discordant retention among
mother-child pairs were found. Prioritization of a family-based
care model that has the potential to improve retention for
children and caregivers is recommended.