Barriers and Facilitators of Art Adherence Among Hiv Positive Patients in Community Client-led Art Delivery Groups at Lira Regional Referral Hospital

Abstract Background: The community client-led ART delivery groups (CCLADs) was introduced as one of the strategies to better serve individual needs and reduce unnecessary burdens on the health system. However, no study has comprehensively explained what are the drivers and barriers of CCLADs in improving treatment outcomes. This study sought to assess the barriers and facilitators of ART adherence among HIV positive patients attending CCLADs at Lira Regional Referral Hospital (LRRH), Lira District.Method: We employed a mixed methodology involving 150 study participants between July to August 2020. Quantitative data was obtained from all the participants that were picked through systematic random sampling using a semi-structured questionnaire. Data was entered into SPSS version 23.0 and analyzed at 95% level of significance. We conducted 25 in-depth interviews guided by a checklist. Qualitative data was analyzed through thematic content analysis of major themes that emerged from participants’ responses.Results: Our study found that majority 94.7% (142/150) of the respondents had an optimal adherence (100%) calculated retrospectively based on a 4-day pill uptake recall. In addition, 39.3% (59/150) of participants in CCLADs at LRRH had missed taking a pill in a period of at least 4 weeks. Among all the 104 respondents that had ever missed a medication, the most frequent reason (35% (35/104)) for missing a medication was travelling far away.From qualitative data, social support, patient self-motivation, health education and counselling and guidance were the major facilitators to adherence. On the other hand, lack of food, stigma, forgetfulness, stress, unfair hospital staffs and cultural beliefs were the major perceived barriers to ART adherence.Conclusion/recommendation: Good adherence was attributed to availability of ART at the clinic and an efficient delivery strategy. More health care follow up interventions should be designed to ensure total pill uptake by PLWHIV in communities.

Download Full-text

Association between oral candidiasis and low CD4+ count among HIV positive patients in Hoima Regional Referral Hospital

BMC Oral Health ◽

10.1186/1472-6831-14-143 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

Martina Nanteza ◽

Jayne B Tusiime ◽

Joan Kalyango ◽

Arabat Kasangaki

Keyword(s):

Oral Candidiasis ◽

Cd4 Count ◽

Referral Hospital ◽

Hiv Positive ◽

Regional Referral Hospital

Download Full-text

Frequency of HIV status disclosure, associated factors and outcomes among HIV positive pregnant women at Mbarara Regional Referral Hospital, southwestern Uganda

Pan African Medical Journal ◽

10.11604/pamj.2019.32.200.12541 ◽

2019 ◽

Vol 32 ◽

Cited By ~ 3

Author(s):

Joseph Ngonzi ◽

Godfrey Mugyenyi ◽

Mukasa Kivunike ◽

Julius Mugisha ◽

Wasswa Salongo ◽

...

Keyword(s):

Pregnant Women ◽

Associated Factors ◽

Referral Hospital ◽

Hiv Positive ◽

Hiv Status ◽

Regional Referral Hospital ◽

Hiv Status Disclosure ◽

Status Disclosure ◽

Southwestern Uganda

Download Full-text

Predictors and Patterns of HIV Status Disclosure among HIV Positive Pregnant Women at Mbarara Regional Referral Hospital, South-Western Uganda

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2017.06.00230 ◽

2017 ◽

Vol 6 (6) ◽

Author(s):

Joseph Ngonzi

Keyword(s):

Pregnant Women ◽

Referral Hospital ◽

Hiv Positive ◽

Hiv Status ◽

Regional Referral Hospital ◽

Hiv Status Disclosure ◽

Western Uganda ◽

Status Disclosure

Download Full-text

O498 PREDICTORS AND PATTERNS OF HIV SEROSTATUS DISCLOSURE AMONG HIV POSITIVE PREGNANT WOMEN AT MBARARA REGIONAL REFERRAL HOSPITAL (MRRH), WESTERN UGANDA

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(12)60928-x ◽

2012 ◽

Vol 119 ◽

pp. S437-S438

Author(s):

J. Ngonzi ◽

F. Bajunirwe ◽

G. Mugyenyi ◽

P. Mukasa ◽

F. Khan

Keyword(s):

Pregnant Women ◽

Referral Hospital ◽

Hiv Positive ◽

Regional Referral Hospital ◽

Serostatus Disclosure ◽

Hiv Serostatus ◽

Hiv Serostatus Disclosure ◽

Western Uganda

Download Full-text

Prevalence of HIV and Associated Risk Factors Among Infants Born to HIV Positive Mothers Attending Entebbe Regional Referral Hospital.

10.51168/sjhrafrica.v2i3.40 ◽

2021 ◽

Author(s):

◽

KEEFA WAMALA ◽

Ronald Nuwamanya ◽

Moses Muwanga

Keyword(s):

Risk Factors ◽

Referral Hospital ◽

Hiv Positive ◽

People Living With Hiv ◽

Regional Referral Hospital ◽

Hiv Exposed Infants ◽

Hiv Positive Mothers ◽

Hiv Exposed ◽

Associated Risk Factors ◽

Mother To Child

Background: Uganda has an estimated 1.4 million people living with HIV with about 52,000 infections occurring every year. In 2018, 160,000 children were reported to have become infected with HIV. Globally, HIV exposed infants have delayed access to Early Infant Diagnosis (EID) of HIV, thus hampering efforts towards zero new infections. In Uganda, the prevalence of HIV among infants is not recorded, peak mortality for infants born with HIV occurs between 2 and 3 months of age. Vertical transmission of HIV from mother to child is the second commonest route of transmission of HIV in Uganda accounting for 18% of all new infections. This study assessed the prevalence of HIV and associated risk factors among infants born to HIV positive mothers attending Entebbe regional referral hospital. Methodology: a cross-sectional study was conducted at a paediatric ward and Mother-Child Health (MCH) General Department of Entebbe Regional Referral Hospital. The study included 78 HIV-exposed infants whose blood samples were collected and analyzed to know their HIV status and data about risk factors was also collected. Data were collected using questionnaires from mothers. Data were then entered into an Excel spreadsheet and analysed by SPSS Version 20. Results: The prevalence of HIV infection among HIV exposed infants is 5.1%. Delay in child diagnosis, breastfeeding was the factors that increased the risk of mother-to-child transmission of HIV in this study. Conclusion and recommendations: Having such a significant figure greater than the proposed WHO recommendation of less than 5% new infections in infants in the era of the world’s pledge to eliminate MTCT of HIV is unbearable therefore, interventions need to be done to lower this prevalence

Download Full-text

Linkage to intensive adherence counselling among HIV-positive persons on ART with detectable viral load in Gomba district, rural Uganda

AIDS Research and Therapy ◽

10.1186/s12981-021-00349-9 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Rita Nakalega ◽

Nelson Mukiza ◽

Henry Debem ◽

George Kiwanuka ◽

Ronald Makanga Kakumba ◽

...

Keyword(s):

Viral Load ◽

Health Center ◽

Health Facility ◽

Transmission Risk ◽

World Health ◽

Hiv Positive ◽

Art Adherence ◽

Detectable Viral Load ◽

Adherence Support ◽

Adherence Counselling

Abstract Background Antiretroviral therapy (ART) adherence is a primary determinant of sustained viral suppression, HIV transmission risk, disease progression and death. The World Health Organization recommends that adherence support interventions be provided to people on ART, but implementation is suboptimal. We evaluated linkage to intensive adherence counselling (IAC) for persons on ART with detectable viral load (VL). Methods Between January and December 2017, we conducted a retrospective chart review of HIV-positive persons on ART with detectable VL (> 1000 copies/ml), in Gomba district, rural Uganda. We abstracted records from eight HIV clinics; seven health center III’s (facilities which provide basic preventive and curative care and are headed by clinical officers) and a health center IV (mini-hospital headed by a medical doctor). Linkage to IAC was defined as provision of IAC to ART clients with detectable VL within three months of receipt of results at the health facility. Descriptive statistics and multivariable logistic regression analyses were used to evaluate factors associated with linkage to IAC. Results Of 4,100 HIV-positive persons on ART for at least 6 months, 411 (10%) had detectable VL. The median age was 32 years (interquartile range [IQR] 13–43) and 52% were female. The median duration on ART was 3.2 years (IQR 1.8–4.8). A total of 311 ART clients (81%) were linked to IAC. Receipt of ART at a Health Center level IV was associated with a two-fold higher odds of IAC linkage compared with Health Center level III (adjusted odds ratio [aOR] 1.78; 95% CI 1.00–3.16; p = 0.01). Age, gender, marital status and ART duration were not related to IAC linkage. Conclusions Linkage to IAC was high among persons with detectable VL in rural Uganda, with greater odds of linkage at a higher-level health facility. Strategies to optimize IAC linkage at lower-level health facilities for persons with suboptimal ART adherence are needed.

Download Full-text