Factors associated with retention in antiretroviral therapy among adults initiated on treatment at Ogur Health Centre iv, Lira district.

Abstract

The scale up of antiretroviral therapy has led to substantial decline in HIV related morbidity and mortality. Nevertheless, retention which is key in ART remains a major public health challenge. Retention in ART is essential to suppress viral replication, improve immunological and clinical outcomes, decrease the risk of developing ARV drug resistance, and reduce the risk of transmitting HIV. Many factors are, however, claimed to influence retention in ART. This is especially worse for people in a post-conflict rural area like Ogur who do not look at HIV as a problem, but settling down and looking for food.

Objectives

To assess the factors associated with retention in antiretroviral therapy among adults initiated on treatment at Ogur Health Centre IV so as to generate evidence to inform practice for improving retention in ART.

Methods

This was a cross sectional study using both quantitative and qualitative methods for data collection and analysis. Structured questionnaire and data extraction tool were used to collect quantitative data, whereas, Key Informant Interview (KII) guide was used to collect qualitative data. Participants included adult patients 18 years and above, initiated on ART at Ogur HC IV, who had been on treatment for at least 12months prior to the start of the study. Simple random sampling was used to select eligible patients for quantitative data collection, while purposive sampling used to select participants for qualitative data collection. Quantitative data was analyzed using Statistical package – SPSS version 19 and qualitative data using content analysis.

Results

The proportion of ART retention was found to be 76.8%. Factors that were found positively associated with retention in ART were community and family supports, belonging to a group of PLHIV and being married. Factors negatively associated with retention in ART were experiencing of physical violence, inadequate number of health workers in ART clinic, experiencing of pills burden and taking long hours to travel to health facility that translates to transport costs.

Conclusion

The findings of this study suggest that low retention rates are a result of interactions between complex and multidimensional factors that highlight the need for multidimensional interventions that combine preventive, curative and promotive health services delivery.