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41. Toward an understanding of disengagement from HIV treatment and care in Sub-Saharan Africa: a qualitative study

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dc.contributor.author Ware, N.C.
dc.contributor.author Wyatt, M.A.
dc.contributor.author Geng, E.H.
dc.contributor.author Kaaya, S.F.
dc.contributor.author Agbaji, O.O.
dc.contributor.author Muyindike, W.R.
dc.contributor.author Chalamilla, G.
dc.contributor.author Agaba, P.A.
dc.date.accessioned 2015-10-09T14:35:21Z
dc.date.available 2015-10-09T14:35:21Z
dc.date.issued 2013
dc.identifier.citation Ware, N. C., Wyatt, M. A., Geng, E. H., Kaaya, S. F., Agbaji, O. O., Muyindike, W. R., ... & Agaba, P. A. (2013). Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study. PLoS medicine, 10(1), e1001369. en_GB
dc.identifier.uri http://hdl.handle.net/123456789/1670
dc.description.abstract Background: The rollout of antiretroviral therapy in sub-Saharan Africa has brought lifesaving treatment to millions of HIVinfected individuals. Treatment is lifelong, however, and to continue to benefit, patients must remain in care. Despite this, systematic investigations of retention have repeatedly documented high rates of loss to follow-up from HIV treatment programs. This paper introduces an explanation for missed clinic visits and subsequent disengagement among patients enrolled in HIV treatment and care programs in Africa. Methods and Findings: Eight-hundred-ninety patients enrolled in HIV treatment programs in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda who had extended absences from care were tracked for qualitative research interviews. Two-hundred-eighty-seven were located, and 91 took part in the study. Interview data were inductively analyzed to identify reasons for missed visits and to assemble them into a broader explanation of how missed visits may develop into disengagement. Findings reveal unintentional and intentional reasons for missing, along with reluctance to return to care following an absence. Disengagement is interpreted as a process through which missed visits and ensuing reluctance to return over time erode patients’ subjective sense of connectedness to care. Conclusions: Missed visits are inevitable over a lifelong course of HIV care. Efforts to prevent missed clinic visits combined with moves to minimize barriers to re-entry into care are more likely than either approach alone to keep missed visits from turning into long-term disengagement. en_GB
dc.language.iso en en_GB
dc.relation.ispartofseries PLoS medicine, 10(1), e1001369.;
dc.subject Antiretroviral therapy en_GB
dc.subject Disengagement en_GB
dc.subject HIV treatment and care en_GB
dc.subject Sub-Saharan Africa en_GB
dc.subject Africa en_GB
dc.title 41. Toward an understanding of disengagement from HIV treatment and care in Sub-Saharan Africa: a qualitative study en_GB
dc.type Article en_GB


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