Christian Unge|Björn Södergård|Anna Mia Ekström|Jane Carter|Marjory Waweru|Festus Ilako|Anders Ragnarsson|Anna Thorson
Challenges for Scaling up ART in a Resource-Limited Setting: A Retrospective Study in Kibera, Kenya
Karolinska Institutet
determine levels dropout adherence antiretroviral treatment art program subsaharan africas largest urban informal settlement kibera nairobi kenyaretrospective cohort study 830 patients started art january 2005 september 2007 29 dropped program 90 days least last prescribed dose dropout rate 23 per 100 personyears probability retention program 6 12 24 months 083 074 065 respectively twentyseven percent patients overall mean adherence 95 resident kibera significantly associated 11 times higher risk dropoutdespite free drugs low associated costs dropout probabilities study higher adherence art lower compared studies subsaharan africa results illustrate art programs resourcelimited settings kibera risk low adherence retention rates expanding services specific intensified patient support needed minimize risk dropout nonadherence causing future significant health threats individuals also public health