Share this article on:

Loss to Follow-Up of Stable Antiretroviral Therapy Patients in a Decentralized Down-Referral Model of Care in Johannesburg, South Africa

O'Connor, Cara MPH; Osih, Regina MD, MPH; Jaffer, Ambereen MPH

JAIDS Journal of Acquired Immune Deficiency Syndromes: December 1st, 2011 - Volume 58 - Issue 4 - p 429–432
doi: 10.1097/QAI.0b013e318230d507
Brief Report: Epidemiology and Prevention

A retrospective record review was conducted for patients down referred to primary health care facilities between 2007 and 2009 to assess the rate and reported reasons for loss to follow-up among stable antiretroviral patients in a down-referral model of care in Johannesburg, South Africa. Missing patients were traced telephonically. Of 3361 patients down referred, 4.11% were lost to follow-up. Most patients who were lost to follow-up were lost at the transfer stage between initiation and maintenance sites. Decentralization and nurse management of ART should be prioritized to increase access to and retention in HIV/AIDS care.

Wits Reproductive Health and HIV Institute (WRHI).

The clinical activities in inner-city Johannesburg are supported by the South African National and Gauteng Provincial Departments of Health and Social Development with additional funding and support from PEPFAR in a grant from USAID to the Reproductive Health and HIV Research Unit of the University of the Witwaterstrand.

The authors have no funding or conflicts of interest to disclose.

Correspondence to: Cara O'Connor, MPH, Wits Institute for Sexual, Reproductive Health, HIV and Related Diseases, 1605 E. 2nd Street #302 Long Beach, CA 90802 (e-mail:

Received March 8, 2011

Accepted August 1, 2011

© 2011 Lippincott Williams & Wilkins, Inc.