Predictors of attrition among human immunodeficiency virus (hiv) infected youth initiated on antiretroviral treatment in rorya district council, tanzania

Abstract

Background: Retention on HIV care and treatment is an essential pre-requisite in achieving HIV epidemic control as it reduces the chances of treatment failure and further transmission. The burden of HIV infection is higher among youth who also experience higher attrition rates compared to other age groups. Understanding the dynamics of their retention on HIV treatment and predictors of attrition is necessary for establishing streamlined interventions targeting this population. Objective: This study examined the retention and predictors of attrition among HIV-infected youth enrolled on care and treatment in Rorya District Council (DC), Mara region. Methodology: A clinic-based cross sectional study was conducted in Rorya DC, Tanzania. Study participants included all HIV-infected youths who were consecutively initiated on ART between October 2017 and September 2018. Records on participant’s characteristics during enrolment and their clinic visits to a maximum of 12 months after ART initiation were reviewed. The data on specified variables were captured by using a pre-tested structured data collection tool and Stata IC 14 was used for data entry, cleaning and analysis. The proportion of youths retained were determined by descriptive analysis and predictors of attrition were determined via multivariate logistic regression. Results: A total of 253 client’s records meeting the inclusion criteria were collected and analyzed. Overall the retention at 3, 6, and 12 months were 81.4%, 69.2%, and 59.3% respectively. Independent predictors of attrition among youth were being aged 20-24 years (AOR, 5.3, CI: 2.56-10.94), being male (AOR, 6.61, CI: 2.46-17.74), being single or never married (AOR, 4.66, CI: 2.13- 10.23), having a baseline WHO clinical stage 2 or 3 (AOR, O.O2, CI: 1.09-4.63) and reporting having no treatment supporter (AOR, 9.22, CI: 2.38-35.79).

Conclusion: The overall retention of HIV-infected youth initiated on ART is still low with a higher decline in the first three months of ART and only 59.3% are retained by the end of 12 months. Independent predictors of attrition among youth are age, sex, WHO clinical stage 2 and 3, marital status, and having no treatment supporter. Urgent attention to retaining PLHIV youth initiated on treatment is required and should focus to target youths with high risks fo