Factors associated with two years retention in care among adolescents living with HIV in Dodoma municipality

Abstract

ABSTRACT Background: Retention in HIV care services is an essential requirement for adherence to antiretroviral therapy and viral suppression, to avoid significant Human Immunodeficiency Virus-related illness and death. The United Nations Programme on HIV and AIDS 95-95-95 strategy outlines the goal of retaining 95% of individuals enrolled in HIV care. However, achieving this target has been challenging particularly in adolescents aged 10-19 years. To attain the objective of ending the AIDS epidemic by 2030, it is important to understand the demographic and clinical factors that are associated with adolescents’ retention in care. Objective: To assess the factors that are associated with retention in care among adolescents living with HIV/AIDS in Dodoma Municipality. Methodology: This was a retrospective cohort study using data from the Care and Treatment Clinic database. The study involved adolescents between the ages of 10 and 19 living with HIV who were registered and attended CTC services in 5 clinics in Dodoma Municipality between July 2014 and June 2023. The key outcome variable was retention in care. Multivariable modified Poisson regression was used to examine the independent factors associated with retention in care. Relative risks (RR) and 95% confidence intervals (95% CI) are reported. Results: A total of 291 records of adolescents were included; 206 (70.8%) were females. The proportion of adolescents who were retained in care over a 6, 12, and 24-months period was found to be 82.8%, 77.3% and 72.9% respectively. Adolescents aged 10 to 14 years (adjusted RR= 1.49; 95% CI 1.29-1.74) and those initiated on Dolutegravir based regimen (adjusted RR=1.34; 95% CI 1.16-1.54) were more likely to remain in care at 24 months. Conclusion: A two-year retention rate among adolescents living with HIV in Dodoma Municipality was lower than the UNAIDS 2030 target of 95%. Age and ART regimen at initiation were associated with retention in care. Tailored interventions need to be implemented to improve retention in care especially among older adolescents aged 15 to 19 years.