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Adverse childhood experiences and disengagement from HIV care: a case-cohort study in Tanzania
Sydney Tucker1,2, Solis Winters3, Emmanuel Katabaro4
1University of California, Berkeley, United States. sydney.tucker@spi.ox.ac.uk.
Abstract:
Adverse childhood experiences (ACEs) can have lasting, detrimental effects throughout the lifespan and may influence engagement in health care. We conducted a case-cohort study in Tanzania to estimate the association between ACEs and disengagement from HIV care 12 months after initiating antiretroviral therapy (ART) among 217 adults (26 cases and 191 sub-cohort participants). Experiencing one, two, three, and four additional ACEs was significantly associated with 28% (RRa= 1.24; 95% CI: 1.05, 1.44; p-value < 0.01), 64% (RRa=1.64; 95% CI: 1.22, 2.20), 110% (RRa=2.10; 95% CI: 1.35, 3.26), and 168% (RRa=2.68; 95% CI: 1.49, 4.38) increases in the risk of disengagement from HIV care, respectively. These findings call for integrated trauma-informed mental health services within HIV care to end HIV/AIDS as a public health threat.
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