Effectiveness of HIV Linkage to HIV Positive Clients on Treatment in Hospitals in Uganda: The Case of Mengo and Mukono Hospitals HIV Departments
Loading...
Date
2019-09-20
Journal Title
Journal ISSN
Volume Title
Publisher
Health Science Journal
Abstract
The HIV situation remains a challenge with an expected 36.7 million
people infected. In Uganda more than 1,300,000 to 1,600,000 people were living
with HIV/AIDS in 2015 out of 44.27 million Ugandans (UNAIDS, 2017), enrolling
230 HIV new infections daily. Despite of the endeavors in HIV/AIDS testing, linkage
and enrolment remains a major challenge, adding to a majority testing positive
without linkage to care. With this background, the study focused on the analysis
of current prevalence rate, opportunistic infections, deaths, and attitude of those
tested positive towards enrolling for treatment. The study also examined issues
of stigma, denial, distance, negligence, and ignorance. The objectives of the study
were to assess the linkage time lag between the time of testing and the time
of actual enrollment of clients that test HIV positive. It also aimed to check the
reported linkages and actual enrollments and to examine the reasons as to why
those linked for care don’t enroll for HIV care services.
A total of 72 respondents including doctors, HIV positive clients
and counselors were interviewed and secondary data from the hospitals was
analyzed through a mixed methodology approach. The study showed a response
rate of 87.3% analyzed by characteristics of gender, age, relationship and level
of education. However, the study employed mostly qualitative techniques,
though quantitative strategies were obtained. Data collection strategies included
personal interviews and key informant interviews which were unstructured, and
documentation. Findings show the median enrollment into care was 7 hours in females
and 24 hours in Males at p-value <0.001 level of significance. Furthermore the
study shows that one hour increase in time lag to arrive at enrolment point was
associated with 11% increased risk of non-enrolment (uRRs=1.11, 95%CI=1.0-1.2).
Approximately there is a gap of 40% between total tests and enrollments from
the two hospitals. Some of the reasons given were; stigma, denial, family issues,
distance and health expenses.
The study concluded that many clients, especially men (40%), are not
enrolling for care after testing HIV positive. Clients are in denial in the initial stages
of knowing they are HIV positive but are already enrolled for care much later. This
implies that more priority should be at intensifying community-facility linkage and
facility-facility linkage model to bridge the gap. In addition government should
enlarge funding in the HIV section to enhance free treatment. Since research
showed men are most affected, male involvement and partner notifications will
help out in enhancing Men enrollment. With all these combined the linkage gap
would be cubed
Description
Keywords
Citation
Kayiso, M. I., Nakirijja, D. S., & Nassimbwa, F. (2019). Effectiveness of HIV Linkage to HIV Positive Clients on Treatment in Hospitals in Uganda: The Case of Mengo and Mukono Hospitals HIV Departments. Health Science Journal, 13(5), 1-15.