RESEARCH PAPER
Individual, health facility-related, and psychosocial determinants of retention in chronic HIV care among HIV-positive young people in Mukono Municipality, Uganda
 
More details
Hide details
1
Clarke International University, Kampala, Uganda
 
2
Ministry of Health, Kampala, Uganda
 
 
Submission date: 2019-03-26
 
 
Final revision date: 2019-07-16
 
 
Acceptance date: 2019-07-16
 
 
Publication date: 2020-06-28
 
 
HIV & AIDS Review 2020;19(2):99-105
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Retention in care is a known determinant of successful treatment outcome and serves as a measure of abating the emergence of resistant strains of human immunodeficiency virus (HIV). We report on the individual, health facility-related, and psychosocial determinants of retention in chronic HIV care among young HIV-infected patients in Mukono Municipality, in Uganda.

Material and methods:
A cross sectional study included 118 participants, aged 15 to 24 years and health workers, and it was conducted between May and September 2017. Data were obtained using a questionnaire, an abstraction tool, and key informant interviews. Logistic regression analysis was used to establish predictor variables, with a p ≤ 0.05.

Results:
Slightly half, 53.4% of the HIV patients were retained in care for 24 months. Participants with CD4 cell counts above 500 cells/µl at the initiation of treatment were 3 times more likely to be lost to follow-up (odd, 3 : 1). The availability of peer support services (p = 0.026), no extra support from parents/ friends (p = 0.02), stigma and associated blame on others (p = 0.04) showed statistical correlation to the retention in HIV chronic care. On the other hand, peer support services attendance (p = 0.091) and attitude of health providers (p = 0.762) did not show statistical significance in the retention of care of HIV patients.

Conclusions:
The study reports a low retention in HIV care among people aged 15 to 24 years, and this was positively associated with individual, health facility-related, and psychosocial factors, which require intensive efforts to abate such barriers.

REFERENCES (27)
1.
Global AIDS Update. Available at: https://www.scribd.com/documen...; 2017.
 
2.
WHO/UNAIDS/UNICEF. Towards Universal Access. Scaling up priority HIV/AIDS interventions in the health sector. Progress report, 2010.
 
3.
UNAIDS Progress report: Global HIV/AIDS response. Epidemic update and health sector progress towards universal access. Available at: http://whqlibdoc.who.int/publi.... 2011.
 
4.
Uganda Population-Based HIV Impact Assessment UPHIA; 2017.
 
5.
The Uganda HIV and AIDS Country Progress Report; 2016.
 
6.
WHO. Retention in HIV programs; defining the challenges and identifying solutions, meeting report. Geneva: WHO; 2011.
 
7.
Fox MP, Rosen S. Patient retention in antiretroviral therapy programs up to three years on treatment in sub-Saharan Africa: systematic review. Trop Med Int Health 2010; 15 Suppl 1: 1-15.
 
8.
National Antiretroviral Treatment and Care Guidelines for Adults, Adolescents and Children. Available at: http://www.who.int/hiv/amds/ug... (Accessed: 14.03.2017).
 
9.
Ronoh JC, Mwaniki P, Mutai JK, Njenga S, Mutisya AK. Factors associated with retention in care among HIV positive adults attending Pumwani Comprehensive Care Centre, in Nairobi County, Kenya; 2017.
 
10.
Emma SK, Scott B, Michael JM. The HIV treatment cascade and care continuum: updates, goals, and recommendations for the future. AIDS Res Ther 2016; 13: 35.
 
11.
Leslie K. Survey Sampling. 1st ed. New York: John Wiley and Sons; 1965, 45-47.
 
12.
Uganda Bureau of Statistics. The National Population and Housing Census 2014 – Area Specific Profile Series, Kampala, Uganda; 2017.
 
13.
Ministry of Health. Consolidated guidelines for prevention and treatment of HIV in Uganda; 2017.
 
14.
Nakigozi G, Makumbi FE, Kigozi G, et al. Barriers to utilization of HIV care services among adolescents and young adults in Rakai, Uganda: the role of economic strengthening. Global Social Welfare 2015; 2: 105-110.
 
15.
Bergmann H, Pitorak H, Cornman H. Linkage and retention in pre-ART care: best practices and experiences from fourteen countries. Arlington: USAID’s AIDS Support and Technical Assistance Resources, AIDSTAR-One, Task Order 1; 2013.
 
16.
Lahuerta M, Lima J, Nuwagaba-Biribonwoha H, et al. Factors associated with late antiretroviral therapy initiation among adults in Mozambique. PLoS One 2012; 7: e37125.
 
17.
Kuznetsova AV, Meylakhs AY, Amirkhanian YA, et al. Barriers and facilitators of HIV care engagement: results of a qualitative study in St. Petersburg, Russia. AIDS Behav 2016; 20: 2433-2443.
 
18.
Hoffmann M, MacCarthy S, Batson A, et al. Barriers along the care cascade of HIV infected men in a large urban center of Brazil. AIDS Care 2016; 28: 57-62.
 
19.
Buregyeya E, Kulane A, Colebunders R, et al. Tuberculosis knowledge, attitudes and health-seeking behaviour in rural Uganda. Int J Tuberc Lung Dis 2011; 15: 938-942.
 
20.
Geng EH, Glidden DV, Bwana MB, et al. Retention in care and connection to care among HIV-infected patients on antiretroviral therapy in Africa: estimation via a sampling-based approach. PLoS One 2011; 6: e21797.
 
21.
WHO. Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach; 2010.
 
22.
Cheever LW. Engaging HIV-infected patients in care: their lives depend on it. Clin Infect Dis 2007; 44: 1500-1502.
 
23.
Mahy M, Tassie JM, Ghys PD, et al. Estimation of anti-retroviral therapy coverage: methodology and trends. Curr Opin HIV AIDS 2010; 5: 97-102.
 
24.
Mark D, Armstrong A, Andrade C, et al. HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries. J Int AIDS Soc 2017; 20 (Suppl 3): 21591.
 
25.
Darshine G, Nathan F, Katharina K. Risk factors barriers and facilitators for linkage to antiretroviral therapy care; a systematic review AIDS 2012; 26: 2059-2067.
 
26.
Galarraga J. Hispanic-American Culture and Health. Available at: http://www.cwru.edu/med/epidbi... Hispanic_Healthcare.pdf. 2012.
 
27.
Morrison K. Stigma, discrimination, and HIV prevention among MARPS and OVPs: implications for the Caribbean. Caribbean Regional HIV Prevention Summit on Most-at-Risk Populations; 2011.
 
eISSN:1732-2707
ISSN:1730-1270
Journals System - logo
Scroll to top