Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study
Abstract Background Uganda adapted Viral load (VL) testing for monitoring HIV treatment success and virologic failure. However, there is a paucity of data on how the VL testing guidelines are followed in practice in the HIV clinics. This study determined the adherence to national guidelines on VL te...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-06-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-13674-z |
| _version_ | 1818116830999347200 |
|---|---|
| author | Polly Lubega Sylivia Juliet Nalugya Angella Namyalo Kimuli Majoreen Twinokusiima Mercy Khasalamwa Richard Kyomugisa Jane Kabami Asiphas Owaraganise |
| author_facet | Polly Lubega Sylivia Juliet Nalugya Angella Namyalo Kimuli Majoreen Twinokusiima Mercy Khasalamwa Richard Kyomugisa Jane Kabami Asiphas Owaraganise |
| author_sort | Polly Lubega |
| collection | DOAJ |
| description | Abstract Background Uganda adapted Viral load (VL) testing for monitoring HIV treatment success and virologic failure. However, there is a paucity of data on how the VL testing guidelines are followed in practice in the HIV clinics. This study determined the adherence to national guidelines on VL testing, barriers, and associated factors in persons living with HIV (PLHIV) on ART in southwestern Uganda. Methods We conducted a cross-sectional mixed methods study from April to May 2021 at four HIV clinics in southwestern Uganda. Patient chart review using a checklist that captured age, gender, and level of a healthcare facility, dates of ART initiation, dates VL specimens were drawn, line of ART, patient adherence to ART was done. Continuous data were summarized using mean and median and Chi-square was used for categorical data. We performed regression analysis to determine factors associated with adherence to viral load testing guidelines at a 95% level of significance. Key informant interviews with managers of the health facility, ART clinic and laboratory were carried out, and thematic analysis was conducted to explore barriers to adherence to VL testing guidelines. Results The participants’ mean (SD) age was 39.9(± 13.1) years, 39.5% were male, 45.8% received care at a general hospital and median duration on ART was 5 years (IQR;3–7). Of the 395 patient charts reviewed, 317 had their VL testing (80.3%) per the guidelines (defined as up to one month post due date). Receiving care at a hospital (aOR = 2.20; 95%CI 1.30–3.70; p = 0.002) and increasing patient age (aOR = 1.02; 95%CI 1.02–1.06; p = 0.020) were the factors associated with adhering to VL testing guidelines. Long turnaround time of VL results and insufficient VL testing kits were cites by providers as barriers. Conclusion We found suboptimal adherence to VL testing guidelines in PLHIV on ART in southwestern Uganda. Increasing patient age and getting care at a higher-level health facility were associated with guideline-based viral VL testing. Long turnaround time of VL test results and inadequate test kits hindered compliance to VL monitoring guidelines. Strategies that target young PLHIV and lower-level health facilities, increase the stock of consumables and shorten VL results turnaround time are needed to improve adherence to VL testing guidelines. |
| first_indexed | 2024-12-11T04:28:45Z |
| format | Article |
| id | doaj.art-1c25097459bc4426a9162540177b8272 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-11T04:28:45Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-1c25097459bc4426a9162540177b82722022-12-22T01:20:55ZengBMCBMC Public Health1471-24582022-06-012211810.1186/s12889-022-13674-zAdherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods studyPolly Lubega0Sylivia Juliet Nalugya1Angella Namyalo Kimuli2Majoreen Twinokusiima3Mercy Khasalamwa4Richard Kyomugisa5Jane Kabami6Asiphas Owaraganise7Faculty of Medicine, Mbarara University of Science and TechnologyFaculty of Medicine, Mbarara University of Science and TechnologyFaculty of Medicine, Mbarara University of Science and TechnologyFaculty of Medicine, Mbarara University of Science and TechnologyFaculty of Medicine, Mbarara University of Science and TechnologyFaculty of Medicine, Mbarara University of Science and TechnologyDepartment of Nursing, Kabale University School of MedicineInfectious Diseases Research CollaborationAbstract Background Uganda adapted Viral load (VL) testing for monitoring HIV treatment success and virologic failure. However, there is a paucity of data on how the VL testing guidelines are followed in practice in the HIV clinics. This study determined the adherence to national guidelines on VL testing, barriers, and associated factors in persons living with HIV (PLHIV) on ART in southwestern Uganda. Methods We conducted a cross-sectional mixed methods study from April to May 2021 at four HIV clinics in southwestern Uganda. Patient chart review using a checklist that captured age, gender, and level of a healthcare facility, dates of ART initiation, dates VL specimens were drawn, line of ART, patient adherence to ART was done. Continuous data were summarized using mean and median and Chi-square was used for categorical data. We performed regression analysis to determine factors associated with adherence to viral load testing guidelines at a 95% level of significance. Key informant interviews with managers of the health facility, ART clinic and laboratory were carried out, and thematic analysis was conducted to explore barriers to adherence to VL testing guidelines. Results The participants’ mean (SD) age was 39.9(± 13.1) years, 39.5% were male, 45.8% received care at a general hospital and median duration on ART was 5 years (IQR;3–7). Of the 395 patient charts reviewed, 317 had their VL testing (80.3%) per the guidelines (defined as up to one month post due date). Receiving care at a hospital (aOR = 2.20; 95%CI 1.30–3.70; p = 0.002) and increasing patient age (aOR = 1.02; 95%CI 1.02–1.06; p = 0.020) were the factors associated with adhering to VL testing guidelines. Long turnaround time of VL results and insufficient VL testing kits were cites by providers as barriers. Conclusion We found suboptimal adherence to VL testing guidelines in PLHIV on ART in southwestern Uganda. Increasing patient age and getting care at a higher-level health facility were associated with guideline-based viral VL testing. Long turnaround time of VL test results and inadequate test kits hindered compliance to VL monitoring guidelines. Strategies that target young PLHIV and lower-level health facilities, increase the stock of consumables and shorten VL results turnaround time are needed to improve adherence to VL testing guidelines.https://doi.org/10.1186/s12889-022-13674-zAdherenceViral load testingGuidelinesAssociated factorsBarriers |
| spellingShingle | Polly Lubega Sylivia Juliet Nalugya Angella Namyalo Kimuli Majoreen Twinokusiima Mercy Khasalamwa Richard Kyomugisa Jane Kabami Asiphas Owaraganise Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study BMC Public Health Adherence Viral load testing Guidelines Associated factors Barriers |
| title | Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study |
| title_full | Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study |
| title_fullStr | Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study |
| title_full_unstemmed | Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study |
| title_short | Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study |
| title_sort | adherence to viral load testing guidelines barriers and associated factors among persons living with hiv on art in southwestern uganda a mixed methods study |
| topic | Adherence Viral load testing Guidelines Associated factors Barriers |
| url | https://doi.org/10.1186/s12889-022-13674-z |
| work_keys_str_mv | AT pollylubega adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy AT syliviajulietnalugya adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy AT angellanamyalokimuli adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy AT majoreentwinokusiima adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy AT mercykhasalamwa adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy AT richardkyomugisa adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy AT janekabami adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy AT asiphasowaraganise adherencetoviralloadtestingguidelinesbarriersandassociatedfactorsamongpersonslivingwithhivonartinsouthwesternugandaamixedmethodsstudy |