Factors associated with HIV/AIDS patients’ retention into HIV/AIDS care and treatment services in Masaka hospital

Abstract

Background; Poor patient retention and adherence to medications is associated with the development of drug resistance, disease progression and death. The HIV clinic at Masaka hospital has had 17432 clients in total ever enrolled into care and treatment since 2005 and of these, only 8655 were active clients by April 2012. This study was intended to assess factors associated with retention in order to help program implementers in formulating strategic interventions to address problems associated with retention into HIV/AIDS treatment programs. Study objective; To determine the factors associated with retention into HIV/AIDS care and treatment among HIV/AIDS patients in Masaka hospital. Methodology; This was a cross sectional study done at Masaka hospital HIV clinic. A total of 260 clients receiving HIV/AIDS care and treatment (ARVs) for at least three months were interviewed quantitatively. Qualitative interviews with key informants, focus groups and clients lost to follow up were also conducted. Results; A total of 123 (47.31%) had missed clinic appointments at least once. The factors found to be associated with missing clinic appointments at bivariate analysis were; Clients who worked (OR=2.76, 95% CI=1.05 to 7.25), male sex (OR=0.603, 95% CI= 0.37 to 0.99), alcohol abuse (OR=2.613, 95% CI=1.45 to 4.72), and non disclosure of HIV status (OR=0.386, p=0.086). Issues reported from qualitative interviews were; pill burden, feeling that one had recovered from HIV/AIDS, stigma and discrimination, fear of domestic violence, lack of money for transport to the clinic, long waiting time at the clinic and forgetting appointment dates. Conclusion; The main factor associated with poor retention of patients was stigma and discrimination. This calls for fresh massive community sensitization with a focus on employers and people infected and affected by HIV/AIDS to improve retention of HIV/AIDS patients.