Comparing Clinic Retention Between Residents and Nonresidents of Kibera, Kenya

Abstract

We are grateful to Chung et al who, in response to our article, brought forward several interesting issues regarding retention in care and drop-out from antiretroviral treatment (ART) programs in urban slum settings.1 Our article presented research performed at the African Medical and Research Foundation (AMREF) clinic in Kibera, one of Africa’s largest informal settlements, which showed that being a Kibera resident was significantly associated with ART program drop-out. Additionally, the Cox proportional hazard ratio for dropping-out among Kibera residents was 2.45 (P = 0.05), as compared with non–Kibera residents (result not presented in the original article). Chung et al did not find that Kibera residents who attended their study clinic at the Coptic Hope Centre had a higher loss to follow-up (Cox proportional hazard ratio: 1.02) than non–Kibera residents, and thus ‘‘caution against the conclusion that residing in Kibera or any urban slum is a risk factor for poor retention.’’