Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira District

Background. Community HIV testing helps to increase access to high-risk groups who are less likely to visit a clinic for a test. A large proportion of people identified with HIV following community-based testing are not easily linked to care compared to facility-based identified cases. There is a pa...

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Main Authors: Claire Adwar, Steven Sean Puleh, Isaac Ochaba, Isaac Ogweng, Deo Benyumiza, Kosta Amusu, Brenda Achola, Francis Ocen, Lydia Abolo, Edward Kumakech, Celestino Obua
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Advances in Public Health
Online Access:http://dx.doi.org/10.1155/2022/4731006
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author Claire Adwar
Steven Sean Puleh
Isaac Ochaba
Isaac Ogweng
Deo Benyumiza
Kosta Amusu
Brenda Achola
Francis Ocen
Lydia Abolo
Edward Kumakech
Celestino Obua
author_facet Claire Adwar
Steven Sean Puleh
Isaac Ochaba
Isaac Ogweng
Deo Benyumiza
Kosta Amusu
Brenda Achola
Francis Ocen
Lydia Abolo
Edward Kumakech
Celestino Obua
author_sort Claire Adwar
collection DOAJ
description Background. Community HIV testing helps to increase access to high-risk groups who are less likely to visit a clinic for a test. A large proportion of people identified with HIV following community-based testing are not easily linked to care compared to facility-based identified cases. There is a paucity of literature on linkage to HIV care and its predictors particularly following community-based testing in a rural setting. We assessed the level of linkage to the care of HIV-positive individuals and associated factors following community-level identification in Lira district. Method. A cross-sectional survey was conducted in Lira district employing mixed methods among HIV-positive adults identified in the communities. Quantitative data were collected from 329 randomly selected study participants using interviewer-administered questionnaires. Key informant interview guide was used to collect qualitative data. The data were double entered, cleaned, and analyzed using SPSS version 23. Odds ratios and confidence intervals were used to assess the association between predictors of linkage with HIV care. Qualitative data were analyzed using thematic content analysis. Results. The respondents were aged between 18 and 85 years with a mean age of 42.9 (SD = 11.6). The level of linkage to HIV care following community-level identification of HIV testing in Lira district was 98% (95% CI 96.07–99.33). Clients who self-initiated the HIV testing were more likely to link to HIV care than their counterparts (AOR = 9.03; 95% CI 1.271–64.218, p=0.028). Key informants identified factors influencing linkage to care as health education, counseling, follow-up, and family support. Fear of stigma, disclosure, denial, and distance to facility were reported as barriers to linkage. Conclusion/Recommendation. The level of linkage to HIV care following community identification was found to be excellent (98%). Predictors to linkage to care included self-initiated testing, positive perception of distance, and waiting time at health facilities. We recommend health education, counseling, follow-up, and family support as interventions to strengthen successfully linking to care.
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spelling doaj-art-e8046c251ae944d8a16e4cde83f9b54e2025-02-03T06:06:22ZengWileyAdvances in Public Health2314-77842022-01-01202210.1155/2022/4731006Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira DistrictClaire Adwar0Steven Sean Puleh1Isaac Ochaba2Isaac Ogweng3Deo Benyumiza4Kosta Amusu5Brenda Achola6Francis Ocen7Lydia Abolo8Edward Kumakech9Celestino Obua10Lira UniversityLira UniversityLira UniversityLira UniversityLira UniversityLira UniversityLira UniversityLira UniversityLira UniversityLira UniversityMbarara University of Science and TechnologyBackground. Community HIV testing helps to increase access to high-risk groups who are less likely to visit a clinic for a test. A large proportion of people identified with HIV following community-based testing are not easily linked to care compared to facility-based identified cases. There is a paucity of literature on linkage to HIV care and its predictors particularly following community-based testing in a rural setting. We assessed the level of linkage to the care of HIV-positive individuals and associated factors following community-level identification in Lira district. Method. A cross-sectional survey was conducted in Lira district employing mixed methods among HIV-positive adults identified in the communities. Quantitative data were collected from 329 randomly selected study participants using interviewer-administered questionnaires. Key informant interview guide was used to collect qualitative data. The data were double entered, cleaned, and analyzed using SPSS version 23. Odds ratios and confidence intervals were used to assess the association between predictors of linkage with HIV care. Qualitative data were analyzed using thematic content analysis. Results. The respondents were aged between 18 and 85 years with a mean age of 42.9 (SD = 11.6). The level of linkage to HIV care following community-level identification of HIV testing in Lira district was 98% (95% CI 96.07–99.33). Clients who self-initiated the HIV testing were more likely to link to HIV care than their counterparts (AOR = 9.03; 95% CI 1.271–64.218, p=0.028). Key informants identified factors influencing linkage to care as health education, counseling, follow-up, and family support. Fear of stigma, disclosure, denial, and distance to facility were reported as barriers to linkage. Conclusion/Recommendation. The level of linkage to HIV care following community identification was found to be excellent (98%). Predictors to linkage to care included self-initiated testing, positive perception of distance, and waiting time at health facilities. We recommend health education, counseling, follow-up, and family support as interventions to strengthen successfully linking to care.http://dx.doi.org/10.1155/2022/4731006
spellingShingle Claire Adwar
Steven Sean Puleh
Isaac Ochaba
Isaac Ogweng
Deo Benyumiza
Kosta Amusu
Brenda Achola
Francis Ocen
Lydia Abolo
Edward Kumakech
Celestino Obua
Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira District
Advances in Public Health
title Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira District
title_full Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira District
title_fullStr Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira District
title_full_unstemmed Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira District
title_short Factors Associated with Linkage to Care following Community-Level Identification of HIV-Positive Clients in Lira District
title_sort factors associated with linkage to care following community level identification of hiv positive clients in lira district
url http://dx.doi.org/10.1155/2022/4731006
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