Attrition among PLHIV on ART at the Matam CMC, 2017-2022, Guinea

This study, conducted at the Matam Municipal Medical Center, aimed to estimate the incidence of attrition and identify its predictive factors. A retrospective cohort study was conducted on 2,206 patients living with HIV, aged 9 years or older, who initiated ART between March 2017 and February 2022. Attrition was defined as all patients who died or were lost to follow-up (no follow-up for 90 days or more after the last visit). The majority of participants (69.0%) were women with a mean age of 34.04 ± 11.55 years. More than half, or 50.3%, had initiated treatment at WHO clinical stage 3. Nearly 91.3% of patients were on the TDF+3TC+EFV regimen. The incidence of attrition increased gradually between 6 and 36 months of treatment. Factors associated with an increased risk of attrition included a baseline CD4 count < 100 (p < 0.001; HR = 2.151), age between 25 and 35 years (p = 0.010; HR = 1.531), and the presence of tuberculosis (p = 0.001; HR = 1.154). This study highlights a high incidence of attrition and underscores the importance of improving patient retention in ART programs.