Open AccessThe Impact of Universal Test and Treat Program on Highly Active Anti Retroviral Therapy Outcomes (Coverage, Adherence and Lost to Follow Up) at Wangaya Hospital in Denpasar, Bali-Indonesia: A Retrospective Cohort Study
Author(s) -
Ketut Suryana
Publication year - 2021
Publication title -
the open aids journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.812
H-Index - 18
ISSN - 1874-6136
DOI - 10.2174/1874613602115010028
Subject(s) - medicine , retrospective cohort study , human immunodeficiency virus (hiv) , cohort , medical record , chi square test , viral load , pediatrics , emergency medicine , family medicine , statistics , mathematics
Background: World Health Organization (WHO) (2015) recommended that all people diagnosed with human immunodeficiency virus (HIV)-positive initiate Highly Active Anti Retroviral Therapy (HAART) immediately (less than a week), irrespective of CD4 count (Universal Test and Treat / UTT) Program. Objective: To evaluate the impact of UTT as a current therapeutic program on HIV treatment outcomes, coverage, adherence, and lost to follow-up (LTFU) at Wangaya Hospital in Denpasar, Bali, Indonesia. Methods: A Retrospective cohort study was conducted during July 2017 - June 2018 (Pre-UTT) and September 2018 – August 2019 (Post-UTT). Around 402 medical records were selected, reviewed, and enrolled. Data were analyzed using SPSS software for windows version 24.0. Bivariate analysis ( Chi -square test) was performed on all variables with a statistically significant t level of 0.05. Results: Among 4,322 new visitors; 3,585 (82.95%) agreed to take HIV test and 402(11.21%) were confirmed HIV reactive. Most participants confirmed HIV reactive occured at age 25-34 years old and 230 (57.21%) were male. The majority education level were primary (Junior high school) 302(75.12%), 379(94.28%) were employed and 281 (69.90%) stayed in Denpasar. About 350 (87.06%) received HAART, 298 (85.14%) with high adherence and 52 (14.86%) LTFU. Pre-UTT, HAART coverage; 83.03% (181), were statistically significant increased to 91.85% (169) post UTT ( p =0.000). High adherence pre-UTT; 79.56% (144) was significantly increased to 91.12% (154) post UTT ( p =0.006) and LTFU were significantly decreased; 20.44% (37) to 8.87% (15) ( p =0.006). Conclusion:UTT program significantly improve the HIV treatment outcome (increased coverage, adherence, and decreased LTFU).