Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.

<h4>Background</h4>The rollout of antiretroviral therapy in sub-Saharan Africa has brought lifesaving treatment to millions of HIV-infected individuals. Treatment is lifelong, however, and to continue to benefit, patients must remain in care. Despite this, systematic investigations of re...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Norma C Ware, Monique A Wyatt, Elvin H Geng, Sylvia F Kaaya, Oche O Agbaji, Winnie R Muyindike, Guerino Chalamilla, Patricia A Agaba
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/90df769fc7254a858df7599ef56e09ae
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:90df769fc7254a858df7599ef56e09ae
record_format	dspace
spelling	oai:doaj.org-article:90df769fc7254a858df7599ef56e09ae2021-11-18T05:42:46ZToward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.1549-12771549-167610.1371/journal.pmed.1001369https://doaj.org/article/90df769fc7254a858df7599ef56e09ae2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23341753/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>The rollout of antiretroviral therapy in sub-Saharan Africa has brought lifesaving treatment to millions of HIV-infected individuals. Treatment is lifelong, however, and to continue to benefit, patients must remain in care. Despite this, systematic investigations of retention have repeatedly documented high rates of loss to follow-up from HIV treatment programs. This paper introduces an explanation for missed clinic visits and subsequent disengagement among patients enrolled in HIV treatment and care programs in Africa.<h4>Methods and findings</h4>Eight-hundred-ninety patients enrolled in HIV treatment programs in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda who had extended absences from care were tracked for qualitative research interviews. Two-hundred-eighty-seven were located, and 91 took part in the study. Interview data were inductively analyzed to identify reasons for missed visits and to assemble them into a broader explanation of how missed visits may develop into disengagement. Findings reveal unintentional and intentional reasons for missing, along with reluctance to return to care following an absence. Disengagement is interpreted as a process through which missed visits and ensuing reluctance to return over time erode patients' subjective sense of connectedness to care.<h4>Conclusions</h4>Missed visits are inevitable over a lifelong course of HIV care. Efforts to prevent missed clinic visits combined with moves to minimize barriers to re-entry into care are more likely than either approach alone to keep missed visits from turning into long-term disengagement.Norma C WareMonique A WyattElvin H GengSylvia F KaayaOche O AgbajiWinnie R MuyindikeGuerino ChalamillaPatricia A AgabaPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 10, Iss 1, p e1001369; discussion e1001369 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Norma C Ware Monique A Wyatt Elvin H Geng Sylvia F Kaaya Oche O Agbaji Winnie R Muyindike Guerino Chalamilla Patricia A Agaba Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.
description	<h4>Background</h4>The rollout of antiretroviral therapy in sub-Saharan Africa has brought lifesaving treatment to millions of HIV-infected individuals. Treatment is lifelong, however, and to continue to benefit, patients must remain in care. Despite this, systematic investigations of retention have repeatedly documented high rates of loss to follow-up from HIV treatment programs. This paper introduces an explanation for missed clinic visits and subsequent disengagement among patients enrolled in HIV treatment and care programs in Africa.<h4>Methods and findings</h4>Eight-hundred-ninety patients enrolled in HIV treatment programs in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda who had extended absences from care were tracked for qualitative research interviews. Two-hundred-eighty-seven were located, and 91 took part in the study. Interview data were inductively analyzed to identify reasons for missed visits and to assemble them into a broader explanation of how missed visits may develop into disengagement. Findings reveal unintentional and intentional reasons for missing, along with reluctance to return to care following an absence. Disengagement is interpreted as a process through which missed visits and ensuing reluctance to return over time erode patients' subjective sense of connectedness to care.<h4>Conclusions</h4>Missed visits are inevitable over a lifelong course of HIV care. Efforts to prevent missed clinic visits combined with moves to minimize barriers to re-entry into care are more likely than either approach alone to keep missed visits from turning into long-term disengagement.
format	article
author	Norma C Ware Monique A Wyatt Elvin H Geng Sylvia F Kaaya Oche O Agbaji Winnie R Muyindike Guerino Chalamilla Patricia A Agaba
author_facet	Norma C Ware Monique A Wyatt Elvin H Geng Sylvia F Kaaya Oche O Agbaji Winnie R Muyindike Guerino Chalamilla Patricia A Agaba
author_sort	Norma C Ware
title	Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.
title_short	Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.
title_full	Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.
title_fullStr	Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.
title_full_unstemmed	Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.
title_sort	toward an understanding of disengagement from hiv treatment and care in sub-saharan africa: a qualitative study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/90df769fc7254a858df7599ef56e09ae
work_keys_str_mv	AT normacware towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy AT moniqueawyatt towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy AT elvinhgeng towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy AT sylviafkaaya towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy AT ocheoagbaji towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy AT winniermuyindike towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy AT guerinochalamilla towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy AT patriciaaagaba towardanunderstandingofdisengagementfromhivtreatmentandcareinsubsaharanafricaaqualitativestudy
_version_	1718424799945949184

Toward an understanding of disengagement from HIV treatment and care in sub-Saharan Africa: a qualitative study.

Ejemplares similares