Factors Associated with Men Engagement in HIV Continuum of Care in Rwanda: A Cross Sectional Study to Identify Gaps to be Closed Towards HIV Epidemic Control in Rwanda

Abstract

Despite the global achievements to control HIV epidemic and end AIDS by 2030, there is still a discrepancy in accessing HIV services. Men are among the population that are lagging behind when it comes to consuming available services to mitigate the impact of HIV/AIDS. We conducted this study to determine the level of Rwandan men engagement in HIV services delivery. We used cross- sectional design to analyze data from a Population- based HIV impact assessment, a household-based survey conducted in Rwanda from October 2018 to March 2019. Cascade from awareness of the HIV status, linkage to ART and Viral load suppression were analyzed. Logistic regression analysis was conducted to establish relationship between independent variables and outcomes. Data cleaning and analysis was conducted using SAS 9.4. 13. A total of 821 males aged 15 to 64 years participated in the survey, 302 (2.1%) of them tested positive, 92.2% (95% CI: 89.2-95.2) reported tested once for HIV. Overall, 78.2% (95% CI: 72.4-84) reported to be aware of their status and on ART. 70.5% (95% CI: 63.8-77.2) reported to have suppressed viral load. Married or living together with a partner showed to be 7 times more likely to be on ART vs single or never married (OR: 7.42, 95% CI: (1.75;31.38), P <0.01). Odds of viral load suppression increases with age, and those aged above 55 years showed to be more suppressing their virus (OR: 3.94, (95% CI: 0.92-16.9), P=0.07). Findings from this study revealed the gaps to be closed to include all population in maximizing HIV service delivery.