The transition from pediatric to adult healthcare represents a crucial period for adolescents and youth living with HIV. When this healthcare transition is not properly managed, it can result in negative outcomes such as loss to follow-up (LTFU), increased morbidity, and mortality. Therefore, it is essential to estimate the incidence rate and identify predictors of loss to follow-up among youth living with HIV who transitioned from pediatric to adult, especially given the limited evidence available in the study area. A retrospective cohort study was conducted at Gambella General Hospital with 452 HIV-positive youth enrolled in HIV care between January 1, 2019, and December 30, 2022. Data were extracted from patient charts via the Kobo Toolbox. The Kaplan‒Meier survival curve was used to estimate the survival time, and log-rank tests were used to compare the survival probabilities. Bivariable and multivariable Cox proportional hazard regression models were fitted to identify predictors of loss to follow-up among youth living with HIV who had transitioned to adult care. An adjusted hazard ratio with 95% confidence intervals (CIs) was used to assess the strength of the associations and their statistical significance. A total of 452 cohorts were followed for 1252.51 person-years of observation (PYO), 52 of which were LTFUs; the overall incidence rate of LTFU was 4.1 (95% CI: 3.1, 5.4) per 100 PYO. The predictors of LTFU included engaging in daily labor (AHR = 3.64; 95% CI: 1.84, 7.22), ambulatory/bedridden functional status (AHR = 2.51; 95% CI: 1.27, 4.95), suboptimal adherence to ART (AHR = 2.48; 95% CI: 1.30, 4.73), CD4 counts below 200 cells/mm3 (AHR = 3.59; 95% CI: 1.73, 7.43), and CD4 counts between 200 and 350 cells/mm3 (AHR = 2.85; 95% CI: 1.29, 6.32). This study underscores LTFU as a significant public health concern among youth who transitioned to adult care. Daily labor, ambulatory/bedridden status, suboptimal ART adherence, and low CD4 counts emerged as predictors of LTFU. Therefore, interventions such as message reminders, early tracing, and adherence interventions, including targeted health education, are crucial, especially for youth with poor clinical profiles.
Dorgi et al. (Mon,) studied this question.