Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

Abstract

Background Retention in HIV care contributes to antiretroviral therapy adherence, which is a key factor for improved treatment outcomes and prevention of drug resistance. However, HIV treatment among the youths is characterized by loss to follow up, poor adherence to ART, risk of treatment failure and high mortality rates compared to young children and adults. There is limited information about factors associated with retention of youths in HIV care in rural settings in Uganda. We aimed to determine retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda. Methods A cross-sectional study was conducted among youths aged 15–24 years who were receiving care at the HIV clinic at Kabuyanda HC IV who had been in care for at least 1 year before the study. We used an interviewer-administered questionnaire to collect socio-demographic information. Participant chart abstraction was used to collect information on HIV clinic attendance. We collected information on HIV related stigma using the 40-item Berger Stigma Scale. Chi-square test and multivariable logistic regression analysis were used to determine the factors associated with retention in HIV care with a significance level of < 0.05. Retention in HIV care was, defined as having sought care at least once per quarter in the 12 months prior to the study. Results We enrolled 102 participants with a mean age of 20.95 (SD ± 3.07) years. Two thirds (65.7%) of the youths had been retained in HIV care in the previous 12 months. In adjusted analyses, being male, married and had perinatally acquired HIV were independently associated with retention in HIV care. The association between HIV related stigma and retention in HIV care was not statistically significant. Conclusion Retaining adolescents and young adults in HIV care in rural southwestern Uganda is still much lower than the WHO target of 90%. Being male, having perinatally acquired HIV and married or in a relationship are associated with retention in HIV care. Interventions targeting adolescents and young adults living with HIV are necessary to improve retention in HIV care to the WHO target of 90%.

Clinical outcomes among adolescents living with HIV in Kenya following initiation on antiretroviral treatment

“…The literature on retention shows mixed results concerning differences by sex. Similar to findings in our study showing higher retention among male ALHIV, a study from Uganda reported being male was independently associated with retention in HIV care [47]. Moreover, a study of prevalence and predictors of retention in care among adolescents in South Africa found male adolescents to be significantly more likely to be retained in care compared to females [48].…”

“Swallowing these drugs every day, you get tired”: a mixed-methods study to identify Barriers and facilitators to retention and HIV Viral Load suppression among the Adolescents living with HIV in TASO Mbale and TASO Soroti centers of excellence

“…The good retention rate is much better than reported in most previous studies. For example, Muwanguzi et al, reported 65% among the adolescents and young people aged 15-24 years [5], 29% by Izudi et al, [21], 69.5% by Cluver et al, [7] and by Zanooni et al, 89% [22] and 35.7%, Nimwesigwa et al, [11]. As for VLS, it was higher than reported by Hlophe et al, [4] at 55%, 65% by Simms et al, [9], 62% in Kenya [23] but lower than by Tugume et al, [6] at 81%.…”

“…Barriers to optimal VLS identi ed include; di culties nding transport money, unfriendly health settings, drug stock outs, prolonged waiting time, unfavorable school timetable, non-disclosure of HIV status and drug side effects [4][5][6][7][8][9][10]. Conversely, identi ed enablers include reliable stock-levels of drugs in the facilities, good attitude of health-workers, availability of transport money, social/family support, and positive peer in uence [4,7,8].…”

Improving Retention and HIV Viral Load Suppression among the Adolescents Living with HIV in TASO Soroti and TASO Mbale Centers of Excellence using Operation Triple Zero Model: A before and after study protocol

“…A more recent one by Muwanguzi et al. [7] reported a slightly better nding, with 65% of adolescents and young adults aged 15-24 years old in southwestern Uganda retained in care within one year. Indeed, routine programmatic data from Uganda showed that one-year retention among the children aged below 10 years was 87% while adolescents aged 10-19 were at 56%, far below the expected 95%.…”