| dc.description.abstract | Introduction: Pregnant and postpartum adolescents aged 15-19 years and young women aged 20-24 years living with HIV are at a higher risk of being lost from antenatal care and ART services. They are also less likely to receive the full package of prevention of mother-to-child transmission (PMTCT) interventions compared to older women living with HIV. While option B-plus policy has led to a reduction in mother-to-child transmission (MTCT) of HIV infection, 14% of exposed infants still get infected with HIV during breastfeeding, which is still high.
Study objective: To determine the level of retention in HIV care and associated factors among breastfeeding young mothers on lifelong ART in selected sites in Soroti district.
Methods: This was an explanatory sequential mixed-methods study design. The quantitative study was a retrospective cohort of 249 young mothers from 1st January 2017 to 31St December 2021 chosen through consecutive sampling. The qualitative study was an exploratory descriptive study involving 18 in-depth interviews with purposively selected young mothers. Quantitative data was analyzed using multilevel mixed-effects logistic regression to assess factors associated with retention and qualitative data was analyzed using both inductive and deductive thematic analysis. Retention in care was measured as a binary outcome at 6 weeks, 10 weeks, 14 weeks, 5 months, 6 months, 9 months, 12 months, 15 months and 18 months.
Results; Participants’ age (15-24 years), disclosure status and viral load at delivery were different at baseline. Retention in care was highest at 6 weeks (83.5%; 95%CI: 78.4-87.7) lowest at 15 months (23.3%; 95%CI: 18.4-29.0) and was (72.7%; 95%CI: 66.8-77.9) at 18 months. Having timely infant PCR done at 6 weeks was associated with retention, OR=0.27(95%CI; 0.15-0.50). The motivators to retention in care were mothers’ attitude towards ART, having disclosed HIV status, support from the health facility, desire to stay alive, friendly health workers and the need to be able to care for their children. The major challenge faced was transport costs because of lack of financial independence.
Conclusion; Retention among young mothers is below the Ministry of Health (MOH) target of 90%. Interventions specifically targeted at enhancing financial independence among the young mothers are required so as to try and improve retention in care in an effort to meet MOH targets and eventually eradicate HIV in Uganda. | en_US |
