The Evolution of HIV Patient Retention and Care in French Guiana: A Broader View From the Système National des Données de Santé

Frontiers in Public Health

Nicolas Vignier¹  Antoine Adenis¹  Sébastien Rabier²  Louise Mutricy²  Florence Huber²  Leila Adriouch²  Aude Lucarelli²  Hélène Duplan³  Etienne Pascolini³  Christine Sudre³  Mathieu Nacher⁴  Jean Marc Wojcik⁵ 

[1] CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana;COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana;Direction du Service Médical de la Sécurité Sociale, Cayenne, French Guiana;Département Formation Recherche Santé, Université de Guyane, Cayenne, French Guiana;General Medicine, Matoury, French Guiana;

关键词: HIV;    cascade of care;    follow-up interruption;    private practice;    French Guiana;   

DOI  :  10.3389/fpubh.2022.823193

来源: DOAJ

【 摘 要 】

BackgroundAlthough the simplification of antiretroviral (AVR) treatment regimens and follow-up has led to fewer constraints for patients with HIV, their follow-up remains of paramount importance to optimize AVR therapy, to detect and prevent HIV-related morbidity, and prevent secondary infections. The problem of follow-up interruption in French Guiana has been persistent and seemingly impervious to efforts to alleviate it.ObjectiveThe objective was to follow the trend of follow-up interruptions and to test the hypothesis that an increasing number of patients was, in fact, followed by private practitioners.MethodUsing the complementary lenses of the hospital HIV cohort and the health insurance information system, we looked at the incidence of follow-up interruption and the proportion of patients followed by private practitioners.ResultsWe tallied 803 persons that were not known to have died and who were lost to follow-up. Over time, hospital outpatients were lost to follow-up significantly sooner. By contrast, there was a significant trend with more and more patients exclusively followed by private practitioners.ConclusionWhile hospital outpatient care remains by far the most common mode of patient care, there seems to be a gradual erosion of this model in favor of private practice.

【 授权许可】

Unknown