Background: Retention in HIV care contributes to antiretroviral therapy adherence, which is a key factor for improved treatment outcomes and prevention of drug resistance. However, HIV treatment among the youths is characterized by loss to follow up, poor adherence to ART, risk of treatment failure and high mortality rates compared to young children and adults. There is limited information about factors contributing to poor retention of youths in rural settings in Uganda. We aimed to determine the extent of retention in HIV care, level of and associated factors among youths aged 15-24 years in rural southwestern Uganda.
Methods: A cross-sectional study was conducted among youths aged 15-24 years who were receiving care at the HIV clinic at Kabuyanda HC IV who had been in care for at least 1 year before the study. We used a researcher administered questionnaire to collect sociodemographic information and retention. We collected information on HIV related stigma using the 40-item Berger Stigma Scale. We used the SPSS chi-square test and regression analysis assess the association between predictors and retention HIV care, at 95% level of confidence and at a level of significance of 0.05. Retention in HIV care was, defined as having sought care at least once per quarter in the 12 months prior to the study.
Results: We enrolled 102 participants with mean age of 20.95 (SD±3.07) years. Two thirds (65.7%) of the youths had been retained in HIV care in the previous 12 months. Retention in HIV care was significantly associated with female gender (AOR: 0.15, 95%CI 0.03-0.69, p=0.015), being a ‘Mukiga’ by tribe (AOR: 5.77, 95%CI 1.76-18.91, p=0.004) and being married or in a relationship (AOR: 0.18, 95%CI 0.06-0.53, p=0.002). The association between HIV related stigma and retention in HIV care was non-statistically significant.
Conclusion: Retaining adolescents and young adults in HIV care in rural southwestern Uganda is still much lower than the WHO target of 90%. Being female and married or in a relationship are associated with good retention in HIV care. Interventions targeting adolescents and young adults are necessary to improve retention in HIV care to the WHO target of 90%.