Preferences for services in a patient’s first six months on antiretroviral therapy for HIV: The PREFER study

By  Nkosinathi Ngcobo  |  | 


  • In sub-Saharan Africa, interruption in HIV treatment is most common in the first six months after starting ART
  • In SA, 26% were lost to follow up by 6 months (Aurum, 2020)
  • Likely reasons for high attrition in first six months include:

Better patient condition (higher CD4 counts) at initiation, reducing commitment to lifelong adherence

Logistical barriers to accessing care (time, travel costs, etc.)

High and increasing proportion of re-initiators, who have already defaulted at least once and may face the same barriers again

  • Differentiated service delivery (DSD) models exclude patients on ART < 6 months, who are considered “not established” – a gap in treatment models for this period2
  • Retain6 focuses on patients’ first 6 months on ART
    Includes prospective observational data collection – the PREFER survey

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