Retention and sustained viral suppression in HIV patients transferred to community refill centres in Kinshasa, DRC

Abstract

Setting: In 2010, Médecins Sans Frontières set up decentralised community antiretroviral therapy (ART) refill centres ("poste de distribution communautaire", PODI) for the follow-up of stable human immunodeficiency virus (HIV) patients.

Objective: To assess retention in care and sustained viral suppression after transfer to three main PODI in Kinshasa, Democratic Republic of Congo (DRC) (PODI Barumbu/Central, PODI Binza Ozone/West and PODI Masina I/East).

Design: Retrospective cohort study using routine programme data for adult HIV patients transferred from Kabinda Hospital to PODIs between January 2015 and June 2017.

Results: A total of 337 patients were transferred to PODIs: 306 (91%) were on ART for at least 12 months; 118 (39%) had a routine "12-month" viral load (VL) done, 93% (n = 110) of whom had a suppressed VL <1000 copies/ml. Median time from enrolment into PODI to 12-month routine VL was 14.6 months (IQR 12.2-20.8). Kaplan-Meier estimates of retention in care at 6, 12 and 18 months after enrolment into PODIs were respectively 96%, 92% and 88%.

Conclusion: Retention in care and viral suppression among patients in PODI with VL results were better than patients in clinic care and national outcomes.

Keywords: HIV/AIDS; VL suppression; community-based ART supply; retention in care; stable PLWHA.

Conflict of interest statement

Conflicts of interest: none declared.

© 2020 The Union.

Figures

FIGURE 1.

Number and proportion of PLWHA with routine VL done and VL suppressed after transfer from Kabinda Centre to PODI East, West and Central, January 2015–June 2017, Kinshasa, DRC. PLWHA = people living with human immunodeficiency virus/acquired immune-deficiency syndrome; VL = viral load; PODI = poste de distribution communautaire; DRC = Democratic Republic of Congo.

FIGURE 2.

Kaplan-Meier plot of retention in care in PODI at time of transfer of PLWHA from Kabinda Centre to PODI East, West and Central, January 2015–June 2017, Kinshasa, DRC. PODI = poste de distribution communautaire; PLWHA = people living with human immunodeficiency virus/acquired immune-deficiency syndrome; DRC = Democratic Republic of Congo.