Evaluation of factors contributing to missed and lost HIV positive clients on HIV care and treatment: a case at Omugo HC IV

Abstract

The HIV/AIDS epidemic is a significant global public health challenge, with an estimated 39 million people living with HIV worldwide as of 2022 (Nachega,2023 et al). Since the beginning of the epidemic, approximately 85.6 million people have been infected with the HIV virus, and about 40.4 million people have died of HIV-related illnesses (Simanjuntak,2023). The WHO African Region remains the most severely affected, with nearly 1 in every 25 adults living with HIV(WHO,2023). Globally, progress has been made in reducing new HIV infections, with an estimated 1.3 million individuals worldwide acquiring HIV in 2022, marking a 38% decline since 2010 and 59% since the peak in 1995((Nachega,2023 et al). However, women and girls accounted for 46% of all new HIV infections in 2022, highlighting the need for targeted interventions for these populations ((Nachega,2023 et al). In Africa particularly in sub-Saharan Africa. with countries like South Africa, Nigeria, Mozambique, Uganda, and Kenya having high prevalence rates (Manganyi,2020). The region accounts for 71% of the global burden of HIV infection (Kharsany,2020). In 2013, an estimated 35.0 million people were living with HIV in sub-Saharan Africa, with South Africa, Nigeria, Mozambique, Uganda, Tanzania, Zambia, Zimbabwe, Kenya, Malawi, and Ethiopia accounting for almost 80% of all people living with HIV (Kharsany,2020). The epidemic has had devastating social and economic consequences, leading to millions of AIDS orphans without a future (Greenwood,2019 et al). The prevalence of HIV/AIDS in Uganda has been high historically, with significant efforts made to address the epidemic. In the 1990s, Uganda had prevalence rates as high as 18-30%, but by the late 2000s, the prevalence rate had decreased to around 6.5% (Vithalani,2018 et al). However, reports in 2012 indicated a rise in new HIV infections, leading to an increased prevalence rate of up to 7.3% (Vithalani,2018 et al). However, with progress made in reducing new infection, achieving viral suppression and maintaining continuity of treatment, the efforts have been stagnated by cases of missed and lost clients, this refers to patients who fail to attend scheduled appointments or become disengaged from care, leading to negative outcomes such as treatment interruptions, increased viral loads, and higher transmission rates (Lowane,2022 et al, Nabaggala,2018 et al). Missed appointments can result in deleterious clinical outcomes, including virologic failure, thereby increasing morbidity and mortality (Lowane,2022 et al). In addition, missed appointments can interfere with appropriate care for patients and result in wasted medical and administrative resources (Lowane,2022 et al). This is therefore stagnating Uganda’s effort to reducing and eliminating HIV by 20230.It is against this background that the researcher seeks to investigate the factors contributing to missed and lost clients