Factors associated with retention in care among people living with HIV/AIDS in Ubungo Municipality, Tanzania
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Date
2021-12-01
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Kamuzu University of Health Sciences
Abstract
Globally, approximately 50% of people who have been diagnosed with HIV are
either not linked to a care provider or not retained in medical care. In sub-Saharan Africa 54% of
those who are not yet eligible for ART were lost to follow-up before becoming eligible, while 32%
of the people living with HIV who were eligible for ART were lost before initiating treatment.
Although the retention rate of HIV infected people in Tanzania has increased slowly from 39.4%
to 54.5% from 2008 to 2016, there remains some challenges in achieving optimal rates.
A convergent mixed method design was used to determine factors associated with
retention in care among PLHIV at Ubungo municipality, Tanzania. Quantitatively, a descriptive
cross -sectional design was applied and data was collected using an interviewer-administered
questionnaire among 365 participants that were systematically selected. Quantitative data were
analyzed using SPSS software and descriptive statistics was used to summarize findings in tables,
graphs and charts. In addition, Chi square test was used to determine the factors associated with
retention in HIV care. Qualitatively, we conducted a descriptive study and drew a purposive
sample of 18 participants for In-depth Interviews and 18 health care workers for Key informant
Interviews (KII). All data were digitally recorded and then transcribed, translated, coded, analyzed
thematically. The data collection was conducted between May and July 2021.
Ninety-three percent (93%) of the participants were retained in HIV/AIDS care. The
majority (81.1%) never missed their clinic appointments. The main reason for missing a clinic
appointment was forgetfulness. Eighty-seven per cent of the participants were aware of the risks
of missing appointments. However, 94.8% participants continued using the ARVs despite missing
the clinic appointment and obtained drugs from friends, relatives or another clinic. Only 1.1% of
the participants were lost to follow-up. All socio- demographic charactersitics, sex, age, marital
status, education level and occupation were not associated with retention. However, sense of
wellness and good worker’s attitude were related to reported retention during the Key informant
and in-depth interviews.
The study reports a high rate of retention on HIV/AIDS care and treatment attributed
to awareness of alternative clinics to collect the ARVs from and the consequences of missed appointment.
Health care workers should strengthen counselling efforts to further minimize the
rates of missed clinic appointments of longer than six months, focusing om factors associated with
poor retention in HIV/AIDS care and treatment.