OBJECTIVES: Kenya remains a high HIV prevalence country with average prevalence of 4.9% and regional variation ranging from 21% to 0.1%l. In spite of the government rolling out antiretroviral treatment (ART), treatment adherence remains at sub-optimal levels. This study sought to determine the incidence and factors associated with lost to follow up (LTFU) among HIV positive patients on ART in Homa Bay County Referral Hospital. The county’s HIV prevalence is 20.7%. We define loss to follow up as a patient missing a clinic visit for more than 90 days from the time of expected visit.

METHODS:We used a retrospective cohort study and secondary collected data collected from 1303 patients started on ART between 2014 and 2016 and followed up untill 29^thMay 2017 from electronic medical records. Kaplan Maier and Cox regression analysis method.

RESULTS: Study found 929 (71%) patients active on treatment, 300 (23%) reported as LTFU while 5% were transferred out and 1% reported as dead. The overall incidence rate for LTFU was 15.36 per 100 person-years. After covariate adjustment, the patients who were never married (uHR = 1.39, 95% CI [1.05-1.83],); WHO stage I (uHR = 2.02, 95% CI [1.49-2.74], p = <0.001) and stage V (uHR = 2.63, 95% CI [1.65-4.21], p = <0.001); baseline CD4 count < 500 (uHR = 1.80, 95% CI [1.27-2.53], p = 0.001); VL >1000(uHR = 3.30, 95% CI [1.95-5.59], p = <0.001); and no reported OIs (uHR = 1.93, 95% CI [1.53-2.44], p = <0.001) had higher risk of LTFU.

CONCLUSIONS: This study highlights the high rates of LTFU in HIV programs in Kenya. The Test and Treat strategy has led to increased risks of LTFU as fairly healthy clients are enrolled to lifelong ART. HIV programs should have interventions targeting the patients at risk of loss to follow-up.