TitleRetention on Antiretroviral Therapy in South Africa: Evidence from a Systematic Review 2008-2013
AuthorsSydney Rosen, Matthew Fox
PublisherHealth Economics and Epidemiology Research Office (HE2RO)
Large scale, public sector provision of antiretroviral therapy (ART) for HIV/AIDS began in South Africa in 2004. Since then, up to 2.4 million patients are reported to have initiated ART1. Mortality has fallen and life expectancy risen2, ART patients are returning to the workforce3,4, 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 globally5. A recent literature review estimated that roughly 74% of adult patients in Africa are retained two years after starting ART6. 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 years7–9. As part of a broader systematic literature review10 and at the request of the National Department of Health of the Republic of South Africa, we identified recent publications and abstracts that report retention of South African adults on ART. This policy brief summarizes the results of the South Africa analysis.
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