| Title |
Assessing linkage to and retention in care among HIV patients in Uganda and identifying opportunities for health systems strengthening: a descriptive study
|
|---|---|
| Published in |
BMC Infectious Diseases, March 2018
|
| DOI | 10.1186/s12879-018-3042-8 |
| Pubmed ID | |
| Authors |
Caroline E. Boeke, Vennie Nabitaka, Andrea Rowan, Katherine Guerra, Arnold Kabbale, Barbara Asire, Eleanor Magongo, Pamela Nawaggi, Vivienne Mulema, Betty Mirembe, Victor Bigira, Andrew Musoke, Cordelia Katureebe |
| Abstract |
While antiretroviral therapy (ART) availability for HIV patients has increased dramatically in Uganda, patient linkage to and retention in care remains a challenge. We assessed patterns of engagement in care in 20 Ugandan health facilities with low retention based on national reporting. We assessed patient linkage to care (defined as registering for pre-ART or ART care at the facility within 1 month of HIV diagnosis) and 6-month retention in care (having a visit 3-6 months after ART initiation) and associations with patient-/facility-level factors using multivariate logistic regression. Among 928 newly HIV-diagnosed patients, only 53.0% linked to care within 1 month. Of these, 83.7% linked within 1 week. Among 678 newly initiated ART patients, 14.5% never returned for a follow-up visit at the facility. Retention was 71.7% according to our primary definition but much lower if stricter definitions were used. Most patients were already falling behind appointment schedules at their first ART follow-up (median: 28 days post-initiation vs. recommended 14 days). 27.3% of newly-initiated patients had follow-up appointments scheduled 45+ days apart rather than monthly per national guidelines. Linkage and retention were not strongly correlated with each other within facilities (rs = 0.06; p = 0.82). Females, adolescents, and patients in rural settings tended to have lower linkage and retention in multivariable-adjusted models. Linkage support may be most critical immediately after testing positive, as patients are less likely to link over time. More information is needed on reasons for appointment schedules by clinicians and implications on retention. This study was registered in the Pan African Clinical Trial Registry database (#PACTR201611001756166). |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Venezuela, Bolivarian Republic of | 1 | 50% |
| United States | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Members of the public | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 155 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 155 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 44 | 28% |
| Student > Ph. D. Student | 15 | 10% |
| Researcher | 9 | 6% |
| Student > Bachelor | 9 | 6% |
| Student > Postgraduate | 7 | 5% |
| Other | 22 | 14% |
| Unknown | 49 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 41 | 26% |
| Nursing and Health Professions | 25 | 16% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 3% |
| Biochemistry, Genetics and Molecular Biology | 3 | 2% |
| Business, Management and Accounting | 3 | 2% |
| Other | 18 | 12% |
| Unknown | 61 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 April 2018.
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#18,591,506
of 23,028,364 outputs
Outputs from BMC Infectious Diseases
#5,656
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#257,517
of 331,443 outputs
Outputs of similar age from BMC Infectious Diseases
#89
of 134 outputs
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