Retention of HIV clients in care: A comparative study to highlight the benefit of HIV clinical mentorship program in Nasarawa State, Nigeria.

Background: Retention in care is a critical indicator of the quality of HIV care and a cornerstone for achieving epidemic control. Interruption in treatment (IIT) poses a significant threat to achieving the global 95-95-95 targets and leads to adverse health outcomes. This study assessed the effect of the national clinical mentorship program on retention in care and IIT among HIV clients in Nasarawa State, Nigeria.

Methodology: In the 47 facilities where mentors worked, every client who missed an appointment was tracked immediately. A list of potential IIT clients was generated and followed through by linking those clients to trackers who ensured they were returned to care. Mentors ensured that the process of tracking in the facilities was strengthened as part of their routine mentoring activities including facilitating the release of tracking funds. Data from the Retention and Audit Determination Tool (RADET) for patients reported between November 2021 and August 2022 were extracted and imported into an Excel template. Demographic and clinical program parameters were analyzed using descriptive statistics, bi-variate, and multivariate analysis, including Chi-square and logistic regression. The parameters in the facilities where mentorship was deployed were then compared to pre-deployment parameters.

Results: This study found that a clinical mentorship program reduced the Interruption in treatment (IIT) rate from 7% to 0.5% between 2021 and 2022. Although the 25-34 age group had the highest IIT rate, it decreased from 41.6% to 33.3% after the mentorship program. Tertiary facilities still have the highest IIT rates. Non-pregnant women were more likely to continue with treatment than pregnant women. The mentorship program successfully reduced IIT rates in Nasarawa State.

Conclusion: Clinical mentoring can reduce IIT among HIV patients. The study found a decrease from 7% to 0.5%. Tailored mentorship programs can improve retention in HIV care and reduce IIT rates. Gender-specific barriers should be addressed, and interventions should be customized for pregnant women for better program effectiveness and health outcomes.