Individual, health facility-related, and psychosocial determinants of retention in chronic HIV care among HIV-positive young people in Mukono Municipality, Uganda

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.