Among participants from European countries, women were more likely to be lost to follow-up; in non-Europeans, men were more likely to be lost (Fig. 2). Of all subgroups, men from sub-Saharan Africa had the highest rate of LTFU, at 8.10 (95% CI 6.83–9.56)/100 py, a significantly higher rate than that for sub-Saharan Africa women, at 5.04 (95% CI 4.34–5.84)/100 py. As
shown in Table 2, all male migrant groups, with the exception of men from southern Europe, had a higher hazard of LTFU compared with those from northwestern regions; African men had the greatest hazard. In women, immigrants from sub-Saharan Africa, southern Europe and Latin America/Caribbean were more likely find more to be lost to follow-up. In both men and women, younger patients, and patients with less education, IDU and a higher CD4 cell count at baseline were more prone to LTFU. In contrast, in the time-updated analysis, participants with a higher latest CD4 cell count were less likely to be lost to follow-up: hazard ratios (HRs) were 0.63 (95% CI Lumacaftor nmr 0.53–0.74) in men and 0.64 (95% CI 0.50–0.82) in women. Being on ART at baseline was associated with a lower risk of LTFU. Neither calendar year nor period was associated with LTFU
(all P>0.05; data not shown). The survey showed that 7424 of 8802 patients (84%) receiving care at institutions of the SHCS network during 2008 were participating in the SHCS. The distribution of geographical region of origin according to cohort status is depicted in Table 3. Nonparticipation (i.e. formerly participating and never having participated in the SHCS) was highest among individuals from sub-Saharan Africa (374 of 1186; 32%), followed by northern Africa/Middle East (28 of 109; 26%), Latin America/Caribbean (74 of 329; 22%), eastern Europe/Central Asia (40 of 182; 22%), Thalidomide southeastern Asia (52 of 283; 18%), northwestern regions (733 of 6054; 12%) and southern Europe (77 of 659; 12%) (P<0.001). More than half of all former SHCS participants
(54%) had been infected via IDU. The proportion of women was higher in those who had never participated (43%) and former participants (42%) than in current SHCS participants (30%). The proportion of individuals taking ART ranged from 69% in those who had never participated, to 77% in former participants, to 80% in current SHCS participants. In logistic regression models, men from non-European countries were less likely to participate in the SHCS than Europeans [odds ratio (OR) 2.73; 95% CI 2.29–3.24]. ORs for nonparticipation ranged from 2.80 (95% CI 1.73–4.51) for individuals from southeastern Asia, to 5.31 (95% CI 4.14–6.82) for individuals from sub-Saharan Africa. Women from sub-Saharan Africa (OR 3.01; 95% CI 2.40–3.77) and Latin America/Caribbean (OR 2.10; 95% CI 1.30–3.39) were significantly less likely to participate than those from northwestern regions. IDUs were less likely to participate in the SHCS (OR 2.19; 95% CI 1.81–2.