Longitudinal and survival analysis of a five-year anti-retroviral therapy cohort from Southern India: Progress and challenges in achieving the UNAIDS 95-95-95 targets


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Article type :

Original Article

Author :

Nikhil P Hawal, Padmaja Walvekar, Sonam Bhandurge, Nikhil P Hawal, Padmaja Walvekar, Sonam Bhandurge

Volume :

12

Issue :

4

Abstract :

Problem Considered: India faces an immense challenge in meeting the UNAIDS 95-95-95 HIV treatment targets and requires a clear understanding of long-term treatment outcomes and predictors for retention in care among people living with HIV (PLHIV) in high-burden settings.Materials and Methods: A retrospective cohort study of 2,709 adults initiated on ART (2019–2023) at a district centre in Karnataka assessed 5-year retention, mortality, loss-to-follow-up (LTFU), and virological suppression using Kaplan–Meier and Cox regression analyses.Results: A total of 2,709 PLHIV were included (mean age 38.5 years; 62% male). During follow-up, 54 deaths (2.0%), 129 LTFU (4.8%), and 108 transfers (4.0%) occurred. Viral load testing coverage rose to 82% by year 5; suppression exceeded 90% among those tested but only 66% at the cohort level. Kaplan–Meier estimates showed 5-year retention at 87% (95% CI: 85–89). In multivariable analysis, attrition was associated with suboptimal adherence (

Keyword :

HIV, Antiretroviral therapy, Retention in care, Survival analysis.