Tipping the balance towards long-term retention in the HIV care cascade: A mixed methods study in southern Mozambique

Autor: Elisa López-Varela, Denise Naniche, Carlos Iniesta, Mauro Cuna, Aleny Couto, Maria Maixenchs, Khátia Munguambe, Laura Fuente-Soro, Orvalho Augusto, Raquel González, Edson Bernardo, Rui Guilaze
Jazyk: angličtina
Rok vydání: 2019
Předmět:
RNA viruses
Male
Rural Population
Cross-sectional study
Epidemiology
Human immunodeficiency virus (HIV)
HIV Infections
030312 virology
medicine.disease_cause
Pathology and Laboratory Medicine
Geographical Locations
0302 clinical medicine
Immunodeficiency Viruses
Medicine and Health Sciences
Retention in Care
Public and Occupational Health
030212 general & internal medicine
Mozambique
0303 health sciences
Multidisciplinary
Long term retention
AIDS Serodiagnosis
HIV diagnosis and management
Continuity of Patient Care
Vaccination and Immunization
Medical Microbiology
HIV epidemiology
Research Design
Viral Pathogens
Viruses
Medicine
Female
Pathogens
Behavioral and Social Aspects of Health
Research Article
Adult
Science
Immunology
Antiretroviral Therapy
Research and Analysis Methods
Microbiology
03 medical and health sciences
Antiviral Therapy
Environmental health
Retroviruses
medicine
Humans
Microbial Pathogens
Retrospective Studies
business.industry
Lentivirus
Hiv epidemiology
Organisms
Biology and Life Sciences
HIV
Patient Acceptance of Health Care
Antiretroviral therapy
Long-Term Care
Diagnostic medicine
Health Care
Long-term care
Balance (accounting)
Cross-Sectional Studies
People and Places
Africa
Preventive Medicine
Self Report
business
Zdroj: PLoS ONE, Vol 14, Iss 9, p e0222028 (2019)
Repisalud
Instituto de Salud Carlos III (ISCIII)
PLoS ONE
ISSN: 1932-6203
Popis: BACKGROUND: The implementation of quality HIV control programs is crucial for the achievement of the UNAIDS 90-90-90 targets and to motivate people living with HIV (PLWHIV) to link and remain in HIV-care. The aim of this mixed method cross-sectional study was to estimate the linkage and long-term retention in care of PLWHIV and to identify factors potentially interfering along the HIV-care continuum in southern Mozambique. METHODS: A home-based semi-structured interview was conducted in 2015 to explore barriers and facilitators to the HIV-care cascade among individuals that had been newly HIV-diagnosed in community testing campaigns in 2010 or 2012. Linkage and long-term retention were estimated retrospectively through client self-reports and clinical records. Cohen's Kappa coefficient was calculated to measure the agreement between participant self-reported and documented cascade outcomes. RESULTS: Among the 112 interviewed participants, 24 (21.4%) did not disclose their HIV-positive serostatus to the interviewer. While 84 (75.0%) self-reported having enrolled in care, only 69 (61.6%) reported still being in-care 3-5 years after diagnosis of which 17.4% reported having disengaged and re-engaged. An important factor affecting optimal continuum in HIV-care was the impact of the fear-based authoritarian relationship between the health system and the patient that could act as both driver and barrier. CONCLUSION: Special attention should be given to quantify and understand repeated cycles of patient disengagement and re-engagement in HIV-care. Strategies to improve the relationship between the health system and patients are still needed in order to optimally engage PLWHIV for long-term periods. The author(s) received no specific funding for this work. Sí
Databáze: OpenAIRE
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