Effectiveness of adolescent friendly clinics on Retention among young people on antiretroviral Therapy In Tabora Region Tanzania

Abstract

Background: Adolescent Friendly Health Service (AFHS) meet the needs of young people in this sensitive age as majority of them are going through drastic changes psychologically, mentally, and physically. Adolescent Friendly Health Services are inclusive of all young people with all the key services for young people. Retaining young people on care and treatment clinics has been a challenge in many resources limited countries including Tanzania. Limited studies have been done to access the effectiveness of AFHS clinics in Tanzania. Understanding the effectiveness of youth and adolescent friendly clinics on retention is very important in improving retention. Objective: To determine the effectiveness of adolescent friendly health services in retention among young people enrolled on Antiretroviral Therapy aged 10 to 24 years in Tabora Region, Tanzania from January 2014 to December 2019. Methodology: A retrospective cohort analysis of young people aged 10–24 years receiving ART between January 2014 and December 2019 was conducted. Routine patient data were extracted from CTC2 database, an electronic database used for daily service provision. A sample of 3,695 participants was analyzed: 2,598 in AFHS clinics and 1,097 in non-AFHS clinics in Tabora. The key outcome variable was retention. Multivariable analyses were performed using the logistic regression model to analyze differences in retention rates between AFHS clinics and the young people in standard care, adjusting for other variables of interest. Results: The overall retention at 12 months was significantly higher in AFHS (85.5%) compared to non-AFHS clinics (75%). After adjusting for other factors, the odds of retention were 1.96 times higher among young people attending AFHS clinics than non-AFHS clinics (AOR=1.96; 1.39 – 2.77). WHO staging, treatment regimen, age, sex and marital status were not significantly associated with retention. Conclusion: This study demonstrated that AFHS clinics had effect on retention among young people. These results provide a basis for scaling up AFHS clinics in Tabora region. Furthermore, supportive supervision to existing facilities and mentorship to non-AFHS facilities may be needed to improve health outcomes among young people.