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Factors associated with loss to follow-up after occupational HIV exposure in Cape Town, South Africa: a retrospective cohort study.

Factors associated with loss to follow-up after occupational HIV exposure in Cape Town, South Africa: a retrospective cohort study.
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Papavarnavas NS, Manning K, Conrad F, Govender M, Maartens G,


Papavarnavas NS, Manning K, Conrad F, Govender M, Maartens G, (click to view)

Papavarnavas NS, Manning K, Conrad F, Govender M, Maartens G,

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AIDS research and therapy 2017 04 2114(1) 23 doi 10.1186/s12981-017-0149-8

Abstract
BACKGROUND
There is limited data on factors associated with loss to follow-up (LTFU) of health care workers (HCWs) following occupational exposure to HIV, and most studies were conducted in an era when poorly tolerated antiretrovirals like zidovudine were used.

METHODS
A retrospective cohort study was conducted of HCWs attending a referral hospital’s Occupational Health Clinic in Cape Town, South Africa for post-exposure prophylaxis (PEP) during a period when tenofovir was available. Our primary outcome was LTFU at the 3-month visit. We selected seven variables a priori for our logistic regression model and ensured there were at least 10 outcome events per variable to minimize bias.

RESULTS
Two hundred and ninety-three folders were evaluated for descriptive analysis. LTFU worsened with successive visits: 36% at 6 weeks, 60% at 3 months, and 72% at 6 months. In multivariate analysis at the 3-month visit LTFU was associated with age (adjusted odds ratio (aOR), 0.6 per 10-year increase [95% CI, 0.5-0.9]), HCW category of doctor (aOR 2.7 [95% CI, 1.3-5.5]), and time from exposure to receiving PEP of more than 24 h (aOR 5.9 [95% CI, 1.3-26.9]).

CONCLUSION
We identified factors associated with LTFU of HCWs after occupational HIV exposure, which could be used to target interventions to improve follow-up.

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