Large scale, public sector provision of antiretroviral therapy (ART) for HIV/AIDS began in South Africa in 2004. Since then, up to2.4 million patients are reported to have initiated ART. Mortality has fallen and life expectancy risen, ART patients are returning to the workforce, and the national treatment program is viewed as one of the country’s great successes in public health. Despite the indisputable success of the program, concern about retaining millions of patients on lifelong ART is growing. Long–‐term patient retention on ART is now considered one of the major challenges facing public sector ART programs globally. A recent literature review estimated that roughly74% of adult patients in Africa are retained two years after starting ART. In South Africa, there are signs that adult retention is deteriorating over calendar time, with patients who started ART more recently more likely to be lost than those who initiated in earlier years.
Authors: Sydney Rosen, Matthew Fox