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

article

Hélène Duplan¹  Sébastien Rabier²  Christine Sudre¹  Leila Adriouch²  Aude Lucarelli²  Florence Huber²  Louise Mutricy²  Jean Marc Wojcik³  Nicolas Vignier²  Etienne Pascolini¹  Antoine Adenis²  Mathieu Nacher² 

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

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

DOI  :  10.3389/fpubh.2022.823193

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Although 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. Objective The 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. Method Using 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. Results We 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. Conclusion While 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】

CC BY