Factors Associated with Loss to Follow-Up Among HIV Patients on Antiretroviral Therapy in Borno State

Background: Loss to follow-up among patients on antiretroviral therapy is a critical threat to HIV programme effectiveness and individual patient outcomes, and its determinants in conflict-affected North East Nigeria require empirical elucidation. This study identifies factors associated with loss to follow-up among HIV patients receiving antiretroviral therapy in Borno State. Methods: A retrospective cohort study reviewed electronic patient records of 500 patients who initiated antiretroviral therapy between 2020 and 2022 at the State Specialist Hospital, Maiduguri. Loss to follow-up was defined as absence from clinic for over 90 days without documented transfer or death. Cox proportional hazards regression was used to identify time-dependent predictors. Results: Cumulative loss to follow-up incidence was high. Displacement, non-disclosure of HIV status, poor social support, and distance from facility were independent predictors. Patients initiated on same-day antiretroviral therapy showed comparable retention to those given preparation time. Conclusion: Loss to follow-up from ART programmes in Borno State is driven by conflict-related displacement and structural barriers. Family medicine practitioners must lead community-based differentiated service delivery models including community ART distribution and peer-support programmes to improve retention. Keywords: loss to follow-up, antiretroviral therapy, HIV, Borno State, retention