“It is all about the fear of being discriminated [against]…the person suffering from HIV will not be accepted”: a qualitative study exploring the reasons for loss to follow-up among HIV-positive youth in Kisumu, Kenya

Abstract Background In Malawi, loss to follow-up (LTFU) of HIV-positive pregnant and postpartum women on Option B+ regimen greatly contributes to sub-optimal retention, estimated 74% at 12 months postpartum. This threatens Malawi’s efforts to eliminate mother-to-child transmission of HIV. We investigated factors associated with LTFU among Mother-Infant Pairs. Methods We conducted a qualitative study, nested within the “Promoting Retention Among Infants and Mothers Effectively (PRIME)” study, a 3-arm cluster randomized trial assessing the effectiveness of strategies for improving retention of mother-infant pairs in HIV care in Salima and Mangochi districts, Malawi. From July to December 2016, we traced 19 LTFU women and conducted in-depth interviews with them and also with 30 healthcare workers from health facilities where the LTFU women were receiving care. Recorded interviews were transcribed and translated and, then, analysed using deductive content analysis. Results The following reasons were reported contributing to LTFU: lack of support from husbands or family members; long distance to health facilities; food insecurity; community-level stigma; ART side effects; perceived good health after taking ART and adoption of other alternative HIV treatment options. Conclusion Our study has found multiple factors at personal, family, community and health system level which contribute to poor retention of mother-infant pairs in HIV care. Key words PRIME, PMTCT, EMTCT, loss to follow up, mother-infant pairs, Option B+

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Factors associated with loss-to-follow-up of HIV-positive mothers and their infants enrolled in HIV care clinic: A qualitative study

BMC Public Health ◽

10.1186/s12889-020-8373-x ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

S. Mpinganjira ◽

T. Tchereni ◽

A. Gunda ◽

V. Mwapasa

Keyword(s):

Qualitative Study ◽

Hiv Care ◽

Hiv Positive ◽

Care Clinic ◽

Loss To Follow Up ◽

Factors Associated ◽

Hiv Positive Mothers

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Factors Associated With Loss-to-follow-up Of Hiv-positive Mothers And Their Infants Enrolled In Hiv Care Clinic: A Qualitative Study

10.21203/rs.2.14292/v1 ◽

2019 ◽

Author(s):

Samuel Lawrent Mpinganjira ◽

Timothy Tchereni ◽

Andrews Gunda ◽

Victor Mwapasa

Keyword(s):

Qualitative Study ◽

Health Facilities ◽

System Level ◽

Hiv Care ◽

Hiv Positive ◽

Long Distance ◽

Care Clinic ◽

Loss To Follow Up ◽

Factors Associated

Abstract Background In Malawi, loss to follow-up (LTFU) greatly contributes to sub-optimal retention (74%) of HIV-positive (HIV+) women initiated on antiretroviral therapy (ART) during pregnancy under Option B+ strategy. This threatens Malawi’s efforts to eliminate mother-to-child transmission of HIV. We investigated factors associated with LTFU among Mother-Infant Pairs (MIP). Methods We conducted a qualitative study, nested within the “Promoting Retention Among Infants and Mothers Effectively (PRIME)” study, a 3-arm cluster randomized trial assessing the effectiveness of strategies for improving retention of MIPs in HIV care in Salima and Mangochi districts, Malawi. From July to December 2016, we traced 19 LTFU women and conducted in-depth interviews (IDIs) with them and also with 30 healthcare workers (HCWs) from health facilities where the LTFU women were receiving care. Recorded interviews were transcribed and translated and, then, analysed using deductive content analysis. Results The following reasons were reported contributing to LTFU: lack of support from husbands or family members; long distance to health facilities; food insecurity; community-level stigma; ART side effects; perceived good health after taking ART and adoption of other alternative treatment options. Conclusion Our study has found multiple factors at personal, family, community and health system level which contribute to poor retention of MIPs in HIV care. Key words PRIME, PMTCT, eMTCT, loss to follow up, mother-infant pairs, Option B+

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Factors Associated With Loss-To-Follow-Up Of Hiv-Positive Mothers And Their Infants Enrolled In Hiv Care Clinic: A Qualitative Study

10.21203/rs.2.14292/v3 ◽

2020 ◽

Author(s):

Samuel Lawrent Mpinganjira ◽

Timothy Tchereni ◽

Andrews Gunda ◽

Victor Mwapasa

Keyword(s):

Qualitative Study ◽

Hiv Treatment ◽

Health Facilities ◽

Hiv Care ◽

Hiv Positive ◽

Long Distance ◽

Care Clinic ◽

Loss To Follow Up ◽

Factors Associated

Abstract Background In Malawi, loss to follow-up (LTFU) of HIV-positive pregnant and postpartum women on Option B+ regimen greatly contributes to sub-optimal retention, estimated to be 74% at 12 months postpartum. This threatens Malawi’s efforts to eliminate mother-to-child transmission of HIV. We investigated factors associated with LTFU among Mother-Infant Pairs. Methods We conducted a qualitative study, nested within the “Promoting Retention Among Infants and Mothers Effectively (PRIME)” study, a 3-arm cluster randomized trial assessing the effectiveness of strategies for improving retention of mother-infant pairs in HIV care in Salima and Mangochi districts, Malawi. From July to December 2016, we traced and interviewed 19 LTFU women. In addition, we interviewed 30 healthcare workers from health facilities where the LTFU women were receiving care. Recorded interviews were transcribed, translated and then analysed using deductive content analysis. Results The following reasons were reported as contributing to LTFU: lack of support from husbands or family members; long distance to health facilities; poverty; community-level stigma; ART side effects; perceived good health after taking ART and adoption of other alternative HIV treatment options. Conclusion Our study has found multiple factors at personal, family, community and health system levels, which contribute to poor retention of mother-infant pairs in HIV care. Key words PRIME, PMTCT, loss to follow up, mother-infant pairs, retention, Option B+

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Determinants of loss to follow-up among HIV positive patients receiving antiretroviral therapy in a test and treat setting: A retrospective cohort study in Masaka, Uganda

PLoS ONE ◽

10.1371/journal.pone.0217606 ◽

2020 ◽

Vol 15 (4) ◽

pp. e0217606 ◽

Cited By ~ 1

Author(s):

Julius Kiwanuka ◽

Jacinta Mukulu Waila ◽

Methuselah Muhindo Kahungu ◽

Jonathan Kitonsa ◽

Noah Kiwanuka

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hiv Positive ◽

Loss To Follow Up ◽

Test And Treat

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Pre-ART loss to follow-up in HIV-positive adults at a primary health care center in urban Mozambique

Annals of Global Health ◽

10.1016/j.aogh.2014.08.113 ◽

2014 ◽

Vol 80 (3) ◽

pp. 194 ◽

Cited By ~ 1

Author(s):

J. Ye

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Primary Health Care Center ◽

Hiv Positive ◽

Loss To Follow Up ◽

Health Care Center ◽

Primary Health ◽

Hiv Positive Adults

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Outpatient Medical Care of Injection Drug Use Related HIV

International Journal of STD & AIDS ◽

10.1177/095646249200300204 ◽

1992 ◽

Vol 3 (2) ◽

pp. 96-100 ◽

Cited By ~ 10

Author(s):

R P Brettle ◽

S M Gore ◽

A McNeil

Keyword(s):

Infectious Disease ◽

Drug Use ◽

Injection Drug Use ◽

Injection Drug ◽

Hiv Positive ◽

Initial Increase ◽

Medical Clinic ◽

Loss To Follow Up ◽

Disease Unit

By the end of March 1990 470 HIV positive patients, 77% injection drug use (IDU) related, had attended the outpatient department of the Regional Infectious Disease Unit with a cumulative loss to follow-up of only 20%. Coincident with the prescribing of oral methadone and a specific all-day IDU-related HIV medical clinic the total number of appointments increased from 28/month in May 1986 to 300/month in May 1989 ( P< 0.001) and the number of defaulted appointments decreased from a maximum of 60% (17/28) to 16% (48/294, P<0.001) in these months. There was a significant initial increase in the number of defaulted appointments for the infectious disease (ID) clinics from 11% (77/726) to 16% (124/797, P<0.01) which returned to previous levels once a specific IDU-related HIV clinic was established. There was also a significant decline in the number of new patients referred which was greater for the urinary tract infection clinics (108 to 56 per 6 months, P<0.0001) than for the ID clinics (119 to 88 per 6 months, P<0.05).

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Retaining HIV-positive patients in HIV care: a personalised approach for those at risk of loss to follow-up at an inner city sexual health service

Sexual Health ◽

10.1071/sh17036 ◽

2018 ◽

Vol 15 (1) ◽

pp. 91

Author(s):

Loretta Healey ◽

Catherine C. O'Connor

Keyword(s):

Health Service ◽

Sexual Health ◽

Text Messages ◽

Hiv Care ◽

Hiv Positive ◽

Hiv Patients ◽

Loss To Follow Up ◽

Sexual Health Service ◽

Lost To Follow Up

In 2013 a personalised approach to follow-up of HIV patients who had withdrawn from HIV care was taken at RPA Sexual Health, a Sydney metropolitan sexual health service. HIV patients were telephoned, sent text messages, emailed and sent letters multiple times where applicable. With this intervention 20 of 23 people who had withdrawn from HIV care re-engaged. Since that time, active follow-up of all people diagnosed with HIV has resulted in only 2% of HIV patients at RPA Sexual Health being lost to follow-up.

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