Accepted for/Published in: JMIR Research Protocols
Date Submitted: Apr 23, 2025
Date Accepted: Feb 17, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Factors Associated with Loss to Follow-Up Among People Living with HIV in a Mexican National Tertiary Care Hospital: Protocol and Baseline Analysis of a Prospective Cohort Study
ABSTRACT
Background:
Advances in antiretroviral therapy (ART) have significantly improved the life expectancy of people living with HIV (PLWHIV). However, maintaining retention in care—defined as the ongoing engagement with medical services from diagnosis through regular follow-up—is essential for optimal clinical outcomes. Loss to follow-up (LTFU), defined as the absence of ART prescription refills or medical visits for more than 90 days, can lead to increased mortality, treatment failure, and continued community transmission. Various individual and structural factors have been linked to LTFU, but evidence from the Mexican context remains limited.
Objective:
The objective of this study was to describe the baseline sociodemographic, clinical, and psychosocial characteristics of a recently diagnosed cohort of PLWHIV in order to identify potential factors associated with LTFU.
Methods:
A prospective cohort study was conducted at a national tertiary care hospital in Guadalajara, Jalisco, Mexico. Eligible participants were adults (≥18 years old) who had initiated ART within six months prior to enrollment. Data were collected on sociodemographic, clinical, HIV-related, and psychosocial variables using validated instruments (SMAQ for adherence, Berger’s HIV Stigma Scale, and the MOS-HIV quality of life survey). The primary outcome was LTFU. This report presents a descriptive analysis of baseline data.
Results:
A total of 164 participants were enrolled. The median age was 35 years, with 86% were males. Thirty-nine percent reported no fixed monthly income, and only 30% had formal employment. Most participants lived more than 5 kilometers from the hospital. Fifty-two percent were classified as late presenters (CD4 <200 cells/μL), and 30% were identified as non-adherent to ART at baseline. High levels of perceived stigma and moderate quality-of-life scores were observed across the cohort.
Conclusions:
This baseline analysis highlights significant socioeconomic, clinical, and psychological vulnerabilities among PLWHIV in this setting. These factors may compromise long-term retention in care. The findings emphasize the need for targeted, context-specific interventions to support continued engagement in care and reduce the risk of LTFU in similar populations.
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