Functional status as a predictor of loss to follow-up among people living with HIV on antiretroviral therapy in Tangerang District, Indonesia

Loss to follow-up (LTFU) is a serious threat to the success of HIV treatment programs and is associated with various factors, such as socio-demographic, clinical, and treatment-related factors. Studies that found functional status as a predictor of LTFU in people living with HIV (PLHIV) on antiretroviral therapy (ART) are mostly conducted in the African region, while in the Asian region such studies are still limited. This study aimed to identify the socio-demographic, clinical, and treatment-related predictors of LTFU. This retrospective cohort study was conducted in the Siloam General Hospital, Tangerang, Indonesia. The study population was all adult PLHIV which started ART between January 1, 2017 until May 31, 2023. The outcomes were LTFU, dead, on follow-up, or transferred out. The data was analysed using SPSS Statistics V26. Kaplan–Meier analysis was used to estimate the mean follow up time, ART retention probability, then Cox Regression analysis was used to determine the predictors of LTFU. A total of 177 people living with HIV (PLHIV) on ART were followed for a mean duration of 28.29 months (95% CI: 26.23–30.35 months), while 63 (35.59%) of participants were LTFU at this time period. The probability of PLHIV to remain on ART on the 6th, 12th, and 18th month were 85.2%, 80.7%, and 76.6% respectively. Ambulatory functional status (HR 2.227; 95% CI: 1.323–3.749; p-value = 0.003) was associated with LTFU in univariable Cox Regression, and in the final model of multivariable Cox Regression only ambulatory functional status (HR 2.476; 95% CI: 1.252–4.894; p-value = 0.009) was associated with LTFU. There was a high probability of LTFU during the first six months. PLHIV with ambulatory functional status had double the risk of LTFU than the working category due to their unique conditions. Healthcare providers should identify PLHIV and educate the families of PLHIV to provide support needed by PLHIV with ambulatory functional status to decrease the rate of LTFU.