TY - JOUR
T1 - Implementing an integrated community based health systems strengthening approach to improve HIV survival in Northern Togo
AU - Fiori, Kevin P.
AU - Belli, Hayley M.
AU - Lauria, Molly E.
AU - Hirschhorn, Lisa R.
AU - Schechter, Jennifer
AU - Hansman, Emily
AU - Rajshekhar, Nandita
AU - Katin, Venance
AU - Gbeleou, Sesso
AU - Grunitsky-Bekele, Meskerem
AU - Pitche, Vincent Palokinam
N1 - Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/6/2
Y1 - 2020/6/2
N2 - To disseminate lessons learned from the implementation experience of a public-private sector partnership, we describe a comprehensive HIV/AIDS program including 5-year survival outcomes for individuals who initiated antiretroviral therapy (ART) treatment in Togo from 2010 to 2015. A retrospective case study analysis was conducted from a cohort of patients receiving ART at an HIV/AIDS care clinic in Kara Region, Togo. Kaplan-Meier curves with Log rank tests were used to compare estimated survival curves by demographic and clinical characteristics. Associations were described between survival probability and age, gender, World Health Organization (WHO) disease stage, and timing of ART initiation. Cox proportional hazard model was used to determine predictors of mortality. After approximately five-years since ART initiation (1780 days), there were 114 deaths, with a survival probability of 75.3% (95% CI: 70.3–80.6%). Participants with advanced WHO disease stage were more likely at risk of death relative to patients categorized as WHO Stage 1, with Stage 4 approximately 9 times more likely (aHR 9.22, 95% CI 4.29–19.84). Our study suggests that delivering comprehensive HIV care through a private-public partnership may serve as a model to expand and improve HIV/AIDS care as well as high quality primary care.
AB - To disseminate lessons learned from the implementation experience of a public-private sector partnership, we describe a comprehensive HIV/AIDS program including 5-year survival outcomes for individuals who initiated antiretroviral therapy (ART) treatment in Togo from 2010 to 2015. A retrospective case study analysis was conducted from a cohort of patients receiving ART at an HIV/AIDS care clinic in Kara Region, Togo. Kaplan-Meier curves with Log rank tests were used to compare estimated survival curves by demographic and clinical characteristics. Associations were described between survival probability and age, gender, World Health Organization (WHO) disease stage, and timing of ART initiation. Cox proportional hazard model was used to determine predictors of mortality. After approximately five-years since ART initiation (1780 days), there were 114 deaths, with a survival probability of 75.3% (95% CI: 70.3–80.6%). Participants with advanced WHO disease stage were more likely at risk of death relative to patients categorized as WHO Stage 1, with Stage 4 approximately 9 times more likely (aHR 9.22, 95% CI 4.29–19.84). Our study suggests that delivering comprehensive HIV care through a private-public partnership may serve as a model to expand and improve HIV/AIDS care as well as high quality primary care.
KW - HIV/AIDS
KW - Health systems strengthening
KW - Togo
KW - community health workers
UR - http://www.scopus.com/inward/record.url?scp=85067559267&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067559267&partnerID=8YFLogxK
U2 - 10.1080/09540121.2019.1626342
DO - 10.1080/09540121.2019.1626342
M3 - Article
C2 - 31170827
AN - SCOPUS:85067559267
SN - 0954-0121
VL - 32
SP - 705
EP - 713
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 6
ER -