Project Title

Antiretroviral therapy Outcomes, Barriers and facilitators of Adherence among individuals initiating Treatment following Test and Start guidelines in an urban HIV clinic in Uganda

EDCTP Project Call

Career Development Fellowship (CDF)

Project Objectives

1) To describe treatment outcomes among HIV positive individuals initiated on ART under “Test and Start” guidelines over a 2-year period. 2)To explore barriers and facilitators for linkage into care following HIV diagnosis under “Test and Start” guidelines. 3)To explore barriers and facilitators for adherence to ART among individuals initiated on ART under the “Test and Start” guidelines.

Study Design

Mixed methods using both qualitative and quantitative methods of data collection

Project Summary

Background: World Health Organization (WHO) recommends antiretroviral therapy (ART) for all people with confirmed HIV diagnosis at any CD4+ cell count or clinical stage. There are fears however, that healthy individuals may have poor treatment outcomes due to non-adherence. We seek to assess treatment outcomes, barriers and facilitators of linkage into care and treatment adherence among individuals initiating ART under “Test and Start” guidelines in six urban HIV clinics. Methods: This will be a mixed methods study combining both qualitative and quantitative methods. The quantitative aim will involve retrospective analysis of medical records of all adult HIV-positive individuals initiated on ART at Kisenyi Health Centre IV, Kawaala Health Centre III, Kiswa Health Centre III, Kisugu Health Centre III and Komamboga Health Centre III between January 2017 and January 2018. We shall describe the proportion of participants achieving virological suppression, incidence of opportunistic infections, retention rates, mortality rates and adherence patterns for patients retained on ART at 6,12 and 24months using STATA® software. In-depth Interviews (IDIs) will be conducted in a purposive sample to explore barriers and facilitators of linkage into care and adherence to ART until saturation. Key Informant Interviews (KIIs) will be conducted among healthcare providers to assess barriers and facilitators of linkage into care and adherence to ART. Both IDI and KII sessions will be audio-recorded and transcribed. Transcripts and notes will be translated into English and the word processed text will be coded. Transcripts will be subjected to thematic content analysis using Atlas.ti version 7.0.

Host Organisation

Sites

Current Organisation

Infectious Diseases Institute,College of Health Sciences Makerere University

Current Job Title

Senior Technical Lead Health Evaluation and Applied Research Development Project

Biography