Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis
Background: Despite the effectiveness of antiretroviral therapy (ART) in reducing HIV-related morbidity and mortality, the retention of HIV care remains suboptimal in Southeast Asia. Objective: This systematic review and meta-analysis aimed to investigate the coverage of retention in care and the l...
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Belitung Raya Foundation
2025-05-01
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| Series: | Belitung Nursing Journal |
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| Online Access: | https://www.belitungraya.org/BRP/index.php/bnj/article/view/3719 |
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| _version_ | 1850142465664745472 |
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| author | Sidik Maulana Kusman Ibrahim Iqbal Pramukti Shakira Amirah Yovita Hartantri |
| author_facet | Sidik Maulana Kusman Ibrahim Iqbal Pramukti Shakira Amirah Yovita Hartantri |
| author_sort | Sidik Maulana |
| collection | DOAJ |
| description | Background: Despite the effectiveness of antiretroviral therapy (ART) in reducing HIV-related morbidity and mortality, the retention of HIV care remains suboptimal in Southeast Asia.
Objective: This systematic review and meta-analysis aimed to investigate the coverage of retention in care and the likelihood factors for retention in HIV care among Southeast Asian people living with HIV, to inform targeted interventions and policy improvements.
Methods: Following the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines, this study included observational studies reporting factors associated with retention in HIV care among Southeast Asian adults, with searches conducted in PubMed, Scopus, Cochrane Library, and CINAHL up to July 15, 2024. Demographic and clinical factors were analyzed using a random-effects model with the generalized linear mixed-effect model (GLLM) to estimate proportion and the DerSimonian-Laird method to estimate odds ratios (OR) with 95% confidence intervals (CI), assessing heterogeneity using the I² statistic.
Results: Among the eleven studies with 46,480 pooled participants analyzed, the coverage of retention in care revealed a pooled proportion of 75.2% (95% CI: 66.7-82.1). Significant clinical factors associated with a higher likelihood of retention included high CD4 count (≥200 cells/mm³) (OR 2.17 (95%CI: 1.19-3.97, p = 0.01), WHO stage 3-4 (OR 2.06, 95%CI: 1.09-3.87, p = 0.02), not being on ART (OR 6.88, 95%CI: 1.89-25.06, p = 0.001), hemoglobin levels ≥10 g/dL (OR 0.50, 95% CI: 0.25-0.99, p = 0.04), and demographic factors of employment (OR 1.18, 95% CI: 1.02-1.38; p = 0.03). Other clinical factors, such as HIV stage, TB co-infection, drug abuse/substance use, and hemoglobin levels, did not significantly affect the likelihood of retention. Similarly, demographic factors such as age, gender, education, marital status, and geographic setting also showed no significant impact on likelihood retention.
Conclusion: Retention in care among Southeast Asian people living with HIV was still below 95%. Clinical factors, particularly high CD4 counts, WHO stage, and the absence of ART, were likelihood factors for retention in HIV care, whereas other clinical and demographic factors studied did not show a significant impact. A universal test and treatment strategy is required to improve retention in care.
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| format | Article |
| id | doaj-art-2f157d8982e24f8792e952f555b9e6d7 |
| institution | OA Journals |
| issn | 2477-4073 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Belitung Raya Foundation |
| record_format | Article |
| series | Belitung Nursing Journal |
| spelling | doaj-art-2f157d8982e24f8792e952f555b9e6d72025-08-20T02:29:04ZengBelitung Raya FoundationBelitung Nursing Journal2477-40732025-05-0111310.33546/bnj.3719Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysisSidik Maulana0Kusman Ibrahim1Iqbal Pramukti2Shakira Amirah3Yovita Hartantri4Postgraduate Program of Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, IndonesiaDepartment of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, IndonesiaDepartment of Community Mental Health Nursing, Faculty of Nursing, Universitas PadjadjaranClinical Clerkship Program, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Central Jakarta, IndonesiaDepartment of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Sumedang, IndonesiaBackground: Despite the effectiveness of antiretroviral therapy (ART) in reducing HIV-related morbidity and mortality, the retention of HIV care remains suboptimal in Southeast Asia. Objective: This systematic review and meta-analysis aimed to investigate the coverage of retention in care and the likelihood factors for retention in HIV care among Southeast Asian people living with HIV, to inform targeted interventions and policy improvements. Methods: Following the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines, this study included observational studies reporting factors associated with retention in HIV care among Southeast Asian adults, with searches conducted in PubMed, Scopus, Cochrane Library, and CINAHL up to July 15, 2024. Demographic and clinical factors were analyzed using a random-effects model with the generalized linear mixed-effect model (GLLM) to estimate proportion and the DerSimonian-Laird method to estimate odds ratios (OR) with 95% confidence intervals (CI), assessing heterogeneity using the I² statistic. Results: Among the eleven studies with 46,480 pooled participants analyzed, the coverage of retention in care revealed a pooled proportion of 75.2% (95% CI: 66.7-82.1). Significant clinical factors associated with a higher likelihood of retention included high CD4 count (≥200 cells/mm³) (OR 2.17 (95%CI: 1.19-3.97, p = 0.01), WHO stage 3-4 (OR 2.06, 95%CI: 1.09-3.87, p = 0.02), not being on ART (OR 6.88, 95%CI: 1.89-25.06, p = 0.001), hemoglobin levels ≥10 g/dL (OR 0.50, 95% CI: 0.25-0.99, p = 0.04), and demographic factors of employment (OR 1.18, 95% CI: 1.02-1.38; p = 0.03). Other clinical factors, such as HIV stage, TB co-infection, drug abuse/substance use, and hemoglobin levels, did not significantly affect the likelihood of retention. Similarly, demographic factors such as age, gender, education, marital status, and geographic setting also showed no significant impact on likelihood retention. Conclusion: Retention in care among Southeast Asian people living with HIV was still below 95%. Clinical factors, particularly high CD4 counts, WHO stage, and the absence of ART, were likelihood factors for retention in HIV care, whereas other clinical and demographic factors studied did not show a significant impact. A universal test and treatment strategy is required to improve retention in care. https://www.belitungraya.org/BRP/index.php/bnj/article/view/3719adherenceantiretroviral therapyCD4 countHIV care retentionSoutheast Asia |
| spellingShingle | Sidik Maulana Kusman Ibrahim Iqbal Pramukti Shakira Amirah Yovita Hartantri Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis Belitung Nursing Journal adherence antiretroviral therapy CD4 count HIV care retention Southeast Asia |
| title | Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis |
| title_full | Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis |
| title_fullStr | Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis |
| title_full_unstemmed | Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis |
| title_short | Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis |
| title_sort | retention in hiv care among southeast asian people living with hiv a systematic review and meta analysis |
| topic | adherence antiretroviral therapy CD4 count HIV care retention Southeast Asia |
| url | https://www.belitungraya.org/BRP/index.php/bnj/article/view/3719 |
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