Abstract
BackgroundThe HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. Approximately 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4–1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000–81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The aim of this study therefore, was to explore the factors associated with access to HIV care services among HIV seropositive clients identified by a home based HIV counseling and testing program in Kumi district, eastern Uganda.MethodsIn a cross sectional study conducted in February 2009, we explored predictor variables: socio-demographics, health facility and community factors related to access to HIV care and treatment. The main outcome measure was reported receipt of cotrimoxazole for prophylaxis.ResultsThe majority [81.1 % (284/350)] of respondents received cotrimoxazole prophylaxis (indicating access to HIV care). The main factors associated with access to HIV care include; age 25–34 years (AOR = 5.1, 95 % CI: 1.5–17.1), male sex (AOR = 2.3, 95 % CI: 1.2–4.4), urban residence (AOR = 2.5, CI: 1.1–5.9) and lack of family support (AOR = 0.5, CI: 0.2–0.9).ConclusionsThere was relatively high access to HIV care and treatment services at health facilities for HIV positive clients referred from the Kumi home based HIV counseling and testing program. The factors associated with access to HIV care services include; age group, sex, residence and having a supportive family. Stakeholders involved in providing HIV care and treatment services in similar settings should therefore consider these socio-demographic variables as they formulate interventions to improve access to HIV care services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0379-6) contains supplementary material, which is available to authorized users.
Highlights
The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world
The Ugandan Ministry of Health treatment guidelines recommends that all people living with HIV/AIDS take cotrimoxazole prophylaxis, irrespective of whether they are on antiretroviral therapy (ART) or not [9]
Access to HIV care in this population was considerably high. This could be attributed to the design and implementation of the home based counseling and testing (HBCT) program which ensured that HIV/ AIDS counseling and testing (HCT) services were provided at people’s homes and HIV positive clients were referred to health facilities for care and treatment
Summary
The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4–1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000–81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The morbidity and mortality due to HIV/AIDS is highest in sub Saharan Africa. In Uganda, designated health facilities/chronic HIV care clinics offer comprehensive HIV/AIDS care, treatment and support services to the community. The services offered include: HIV/ AIDS counseling and testing (HCT), clinical, psychosocial, nutritional, legal, economic, family social and community support for clients [6, 7]. The Ugandan Ministry of Health treatment guidelines recommends that all people living with HIV/AIDS take cotrimoxazole prophylaxis, irrespective of whether they are on ART or not [9]. Early diagnosis of HIV infection through HIV counseling and testing and linkage to HIV care facilities is essential in improving the prognosis and survival of HIV infected individuals [10]
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