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Published on: March 30, 2014
Factors associated with access to HIV care services in eastern Uganda: the Kumi home based HIV counseling and testing
David Lubogo1, John Bosco Ddamulira2, Raymond Tweheyo3
1Department of Community Health and Behavioural Sciences, Makerere University, College of Health Sciences, School of Public Health, P.O.Box 7072, Kampala, Uganda. Lubogodad@yahoo.com.
Insights
Access to HIV care is high in Uganda, with factors like age, sex, and urban residence influencing service utilization. Family support also plays a role in improving HIV treatment access for positive clients.
Area of Science:
- Public Health
- Epidemiology
- Global Health
Background:
- HIV/AIDS remains a significant health challenge, particularly in sub-Saharan Africa, with Uganda experiencing high mortality rates.
- Improved access to HIV care and treatment is crucial for averting morbidity and mortality associated with the epidemic.
- Home-based HIV counseling and testing programs identify seropositive individuals needing access to care.
Purpose of the Study:
- To explore factors associated with access to HIV care services.
- To identify predictors of receiving cotrimoxazole prophylaxis among HIV-seropositive clients.
- To inform interventions aimed at improving HIV care access in resource-constrained settings.
Main Methods:
- A cross-sectional study was conducted in Kumi district, eastern Uganda.
- Socio-demographic, health facility, and community factors were explored as predictor variables.
- Receipt of cotrimoxazole for prophylaxis served as the main outcome measure for access to care.
Main Results:
- A high proportion (81.1%) of respondents received cotrimoxazole prophylaxis, indicating good access to HIV care.
- Key factors associated with access included being aged 25-34 years, male sex, and urban residence.
- Lack of family support was negatively associated with access to HIV care.
Conclusions:
- Relatively high access to HIV care and treatment services was observed for clients referred from a home-based testing program.
- Age, sex, residence, and family support are significant socio-demographic variables influencing access to HIV care.
- Stakeholders should consider these factors when designing interventions to enhance HIV care access in similar contexts.
Background:
The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. Approximately 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4-1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000-81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The aim of this study therefore, was to explore the factors associated with access to HIV care services among HIV seropositive clients identified by a home based HIV counseling and testing program in Kumi district, eastern Uganda.
Methods:
In a cross sectional study conducted in February 2009, we explored predictor variables: socio-demographics, health facility and community factors related to access to HIV care and treatment. The main outcome measure was reported receipt of cotrimoxazole for prophylaxis.
Results:
The majority [81.1 % (284/350)] of respondents received cotrimoxazole prophylaxis (indicating access to HIV care). The main factors associated with access to HIV care include; age 25-34 years (AOR = 5.1, 95 % CI: 1.5-17.1), male sex (AOR = 2.3, 95 % CI: 1.2-4.4), urban residence (AOR = 2.5, CI: 1.1-5.9) and lack of family support (AOR = 0.5, CI: 0.2-0.9).
Conclusions:
There was relatively high access to HIV care and treatment services at health facilities for HIV positive clients referred from the Kumi home based HIV counseling and testing program. The factors associated with access to HIV care services include; age group, sex, residence and having a supportive family. Stakeholders involved in providing HIV care and treatment services in similar settings should therefore consider these socio-demographic variables as they formulate interventions to improve access to HIV care services.
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