Factors Associated with Retention in HIV Care Among HIV-Positive Adolescents in Public Antiretroviral Therapy Clinics in Ibanda District, Rural South Western Uganda.

IF 1.5 Q4 INFECTIOUS DISEASES

HIV AIDS-Research and Palliative Care Pub Date : 2023-01-01 DOI:10.2147/HIV.S401611

Christine Nimwesiga, Ivan Mugisha Taremwa, Damalie Nakanjako, Esther Nasuuna

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Abstract

Background: Retention in antiretroviral therapy (ART) care is a key indicator of Human Immunodeficiency Virus (HIV) treatment success as it improves adherence, critical for better treatment outcomes and prevention of drug resistance. HIV treatment among adolescents living with HIV (ALHIV) is characterized by loss to follow-up, poor ART adherence, and eventual death. This study assessed retention in ART care and the associated factors among ALHIV in Ibanda district, rural South Western Uganda.

Methods: This was a retrospective cohort study using clinical data from ALHIV enrolled from 2019 to 2020 in eight health facilities in Ibanda district. Data from the Electronic Medical Record (EMR) system was extracted to assess the associated factors and participants' status two years after enrollment. Data were analyzed using EPIdata version 3.1 in which Univariate and multivariate cox proportional hazard regression analyses were determined. A hazard ratio (HR) at a 95% confidence interval was obtained, and a P-value <0.05 was considered statistically significant.

Results: Eighty-four ALHIV comprising 86.9% (N = 73) females were enrolled. The majority 63.1% (N = 53) resided in semi/peri-urban, and 44.0% (N = 37) stayed less than 5 km from the facility. Only 35.7% (N = 30) were active on ART, while 17 (20.2%) and 36 (42.9%) were lost to follow-up and transfer-outs, respectively. Factors associated with low retention were: ALHIV that moved 5-10Km (HR = 5.371; 95% CI: 1.227-23.5050, p = 0.026), used differential service delivery model was Facility-Based Group (FBG) (HR = 12.419; 95% CI: 4.034-38.236, p < 0.001) and those enrolled on the Young Adolescent Program Support (YAPs) (HR = 4.868; 95CI:1.851-12.803; p = 0.001). Retention reduced with increasing ART duration, ALHIV on (TDF/3TC/EFV) (p < 0.001), lived more than 10Km (p = 0.043) and did not benefit from any intervention (p < 0.001).

Conclusion: Results showed low retention in care and the urgent need to strengthen individual case management strategies for ALHIV, thus interventions focusing on peer support are desired.

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乌干达西南部农村伊班达区公共抗逆转录病毒治疗诊所中艾滋病毒阳性青少年艾滋病毒护理保留的相关因素

背景:坚持抗逆转录病毒治疗(ART)护理是人类免疫缺陷病毒(HIV)治疗成功的一个关键指标，因为它提高了依从性，对更好的治疗结果和预防耐药性至关重要。感染艾滋病毒的青少年接受艾滋病毒治疗的特点是缺乏随访、抗逆转录病毒治疗依从性差和最终死亡。本研究评估了乌干达西南部农村伊班达地区艾滋病病毒感染者在抗逆转录病毒治疗中的保留情况及其相关因素。方法:这是一项回顾性队列研究，使用了2019年至2020年在伊班达区8个卫生机构登记的ALHIV临床数据。从电子病历(EMR)系统中提取数据，以评估相关因素和参与者在入组两年后的状态。数据分析采用EPIdata 3.1版本，采用单因素和多因素cox比例风险回归分析。结果:共纳入84例ALHIV患者，其中86.9% (N = 73)为女性。63.1% (N = 53)的受访者居住在半城市或近郊，44.0% (N = 37)的受访者居住在距离医疗设施不到5公里的地方。只有35.7% (N = 30)的患者在ART治疗中有活性，17例(20.2%)和36例(42.9%)分别失去随访和转移治疗。与低滞留相关的因素有:ALHIV移动5-10Km (HR = 5.371;95% CI: 1.227-23.5050, p = 0.026)，采用的差异服务交付模式为设施基础组(FBG) (HR = 12.419;95% CI: 4.034-38.236, p < 0.001)和参加青少年项目支持(YAPs)的患者(HR = 4.868;95 ci: 1.851 - -12.803;P = 0.001)。滞留率随着抗逆转录病毒治疗时间的增加而降低，ALHIV存活时间(TDF/3TC/EFV) (p < 0.001)超过10Km (p = 0.043)，并且没有从任何干预中获益(p < 0.001)。结论:结果显示ALHIV患者的护理保留率低，急需加强个案管理策略，因此需要以同伴支持为重点的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV AIDS-Research and Palliative Care INFECTIOUS DISEASES-

CiteScore

3.00

自引率

6.70%

发文量

审稿时长

16 weeks

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