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Original Article Factors Associated with Long-term Retention in Antiretroviral Therapy Among People Living with HIV: Evidence from a Tertiary Hospital in Jakarta, Indonesia
Ifael Yerosias Mauleti1orcid , Krishna Adi Wibisana1orcid , Djati Prasetio Syamsuridzal2orcid , Sri Mulyati2orcid , Vivi Lisdawati3orcid , Ika Saptarini4,5corresp_iconorcid , Nurhayati Nurhayati4orcid , Armedy Ronny Hasiguan4orcid , Harimat Hendarwan4orcid

DOI: https://doi.org/10.3961/jpmph.23.512 [Accepted]
Published online: April 30, 2024
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1Department of Internal Medicine, Fatmawati General Hospital, , Jakarta, Indonesia
2General Practisioner Staf, Fatmawati General Hospital, Jakarta, Indonesia
3Directorate of Human Resources, Education and Research, Fatmawati General Hospital, Jakarta, Indonesia
4Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency, Bogor, Indonesia
5Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
Corresponding author:  Ika Saptarini,
Email: ikas003@brin.go.id
Received: 12 November 2023   • Revised: 9 March 2024   • Accepted: 1 April 2024

Objectives
This study investigated factors associated with the retention of people living with HIV on antiretroviral therapy (ART) during the first 3 years of treatment.
Methods
A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years.
Results
In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%., 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤ 200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% CI, 1.05-2.72).
Conclusions
Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.

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JPMPH : Journal of Preventive Medicine and Public Health