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Disengagement from care remains an important challenge. We sought to determine the incidence of and risk factors associated with disengagement from care during — and outcomes for those who disengaged. We also described risk factors for disengagement based on a Cox proportional hazards model, using multiple imputation for missing data.

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The initial cohort study was set up with support from the University of Cape Town to demonstrate the feasibility of ART in a high HIV-burden African setting, using a public health approach to ART provision, generic antiretrovirals and an adherence model predicated on patient education and empowerment. In that it is one of the longest-standing and largest treatment programmes in South Africa, and one in which there continues to be extensive innovation around models of service delivery, there is a great deal of interest in the continued tracking of clinical outcomes and the effectiveness of health service interventions. Current research objectives pertain to: the clinical, epidemiological and operational aspects of expanded service delivery, including paediatric, adolescent and adult patient outcomes; long-term temporal trends in treatment durability; describing virological and immunological monitoring and resistance; and the incidence of HIV-associated conditions, including TB co-infection. Khayelitsha is an open cohort with continuous recruitment.

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