Exploration of factors that influence uptake and retention in ART care and treatment among clients diagnosed HIV positive through Active index testing in Dedza, Malawi.
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Date
2021-07-15
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Kamuzu Univeristy of Health Sciences
Abstract
Study type A qualitative study will be conducted from July to August 2021 in Dedza district, Malawi. Indepth interviews will be conducted among contacts of index clients who have been diagnosed HIV positive.
Problem Despite existing structures provided by department of HIV and the National ART policies coupled with the 2016 universal treatment for all in Malawi, people living with HIV/ AIDS are not initiating or delay in starting ART care. This challenge is huge in clients identified through active index testing. In the sub–Saharan African, less than one third of those identified are linked to care and for those that are linked in care less than three quarters of them continue to be in care Despite the 2016 universal treatment policy, Malawi is still facing the challenges where clients identified through AIT are taking time and some do not show up in the facilities to engage in care. There is limited data on strategies for optimising uptake and retention of AIT clients in care to achieve suppression which may reduce mortality and morbidity rates due to HIV/AIDS.
Objectives of the study
Broad objective 1. To explore factors that influence uptake and retention in ART care and treatment among clients diagnosed HIV positive through Active Index Testing in Dedza Malawi.
Specific objectives 1. To investigate facilitators to initiate and remain in ART care and treatment among HIV clients diagnosed through index testing. 2. To identify potential strategies that can facilitate ART initiation and retention in care among clients diagnosed through index clients and 3. To identify differentiated service delivery models of care to improve linkage and retention in ART care among clients diagnosed HIV positive through AIT.
Methodology The study setting will be Dedza, Malawi in three health facilities that are currently implementing Active index testing. The health facilities are Mtendere, Mua, and Dedza district Hospital. The study population will be contacts of index clients (18 years of age and above) who can willingly consent and are HIV positive diagnosed through Active index testing. In addition, ART providers and expert clients who have been providing ART for not less than 12 months will also be
Commented [CMM1]: Citation removed
Commented [CMM2]: Citation removed
Commented [CMM3]: Objectives in executive summary put in bullets and indicated as broad and specific objectives
15-Jul-2021
Exploration of factors to increase uptake and retention in ART care among AIT client’s version 2.0, 25 June 2021
4
approached and asked to participate in the study. Hence 10 ART providers, 10 expert clients and 20 contacts of indexes that have been diagnosed HIV positive through Active index testing will be asked to participate in the study.
The study will employ maximum variation purposive sampling to study participants from all angles for better understanding of the topic and to achieve heterogeneity. Index clients’ registers in the three facilities will be used to identify contacts who tested positive. All contacts aged 18 and above who can consent and were tested HIV positive regardless of whether they initiated or did not initiate ART care will be earmarked to be enrolled after consenting to participate. While certified ART providers and known expert clients that have been working at the facility for not less than 12 months and are willing to participate will be asked to take part in the study.
Semi structured in-depth interviews will be conducted for data collection. The interviews will be recorded, transcribed and translated into English for analysis. The PI will do the analysis where coding themes will be developed. Social Ecological Model will guide analysis of data in this study.
Expected findings and dissemination Study findings will help health workers to identify barriers and influencers of clients identified HIV positive through active index testing to linkage and continuation in treatment. It will also guide policy makers to come up with targeted interventions to close existing gaps on index testing program across the HIV cascade. Research findings will be disseminated at COMREC and Dedza District Health Office. In addition, the research findings will be disseminated at local and international conferences and manuscripts of results will be submitted for publication in peer reviewed journals
Study type A qualitative study will be conducted from July to August 2021 in Dedza district, Malawi. Indepth interviews will be conducted among contacts of index clients who have been diagnosed HIV positive.
Problem Despite existing structures provided by department of HIV and the National ART policies coupled with the 2016 universal treatment for all in Malawi, people living with HIV/ AIDS are not initiating or delay in starting ART care. This challenge is huge in clients identified through active index testing. In the sub–Saharan African, less than one third of those identified are linked to care and for those that are linked in care less than three quarters of them continue to be in care Despite the 2016 universal treatment policy, Malawi is still facing the challenges where clients identified through AIT are taking time and some do not show up in the facilities to engage in care. There is limited data on strategies for optimising uptake and retention of AIT clients in care to achieve suppression which may reduce mortality and morbidity rates due to HIV/AIDS.
Objectives of the study
Broad objective 1. To explore factors that influence uptake and retention in ART care and treatment among clients diagnosed HIV positive through Active Index Testing in Dedza Malawi.
Specific objectives 1. To investigate facilitators to initiate and remain in ART care and treatment among HIV clients diagnosed through index testing. 2. To identify potential strategies that can facilitate ART initiation and retention in care among clients diagnosed through index clients and 3. To identify differentiated service delivery models of care to improve linkage and retention in ART care among clients diagnosed HIV positive through AIT.
Methodology The study setting will be Dedza, Malawi in three health facilities that are currently implementing Active index testing. The health facilities are Mtendere, Mua, and Dedza district Hospital. The study population will be contacts of index clients (18 years of age and above) who can willingly consent and are HIV positive diagnosed through Active index testing. In addition, ART providers and expert clients who have been providing ART for not less than 12 months will also be
Commented [CMM1]: Citation removed
Commented [CMM2]: Citation removed
Commented [CMM3]: Objectives in executive summary put in bullets and indicated as broad and specific objectives
15-Jul-2021
Exploration of factors to increase uptake and retention in ART care among AIT client’s version 2.0, 25 June 2021
4
approached and asked to participate in the study. Hence 10 ART providers, 10 expert clients and 20 contacts of indexes that have been diagnosed HIV positive through Active index testing will be asked to participate in the study.
The study will employ maximum variation purposive sampling to study participants from all angles for better understanding of the topic and to achieve heterogeneity. Index clients’ registers in the three facilities will be used to identify contacts who tested positive. All contacts aged 18 and above who can consent and were tested HIV positive regardless of whether they initiated or did not initiate ART care will be earmarked to be enrolled after consenting to participate. While certified ART providers and known expert clients that have been working at the facility for not less than 12 months and are willing to participate will be asked to take part in the study.
Semi structured in-depth interviews will be conducted for data collection. The interviews will be recorded, transcribed and translated into English for analysis. The PI will do the analysis where coding themes will be developed. Social Ecological Model will guide analysis of data in this study.
Expected findings and dissemination Study findings will help health workers to identify barriers and influencers of clients identified HIV positive through active index testing to linkage and continuation in treatment. It will also guide policy makers to come up with targeted interventions to close existing gaps on index testing program across the HIV cascade. Research findings will be disseminated at COMREC and Dedza District Health Office. In addition, the research findings will be disseminated at local and international conferences and manuscripts of results will be submitted for publication in peer reviewed journals
Study type A qualitative study will be conducted from July to August 2021 in Dedza district, Malawi. Indepth interviews will be conducted among contacts of index clients who have been diagnosed HIV positive.
Problem Despite existing structures provided by department of HIV and the National ART policies coupled with the 2016 universal treatment for all in Malawi, people living with HIV/ AIDS are not initiating or delay in starting ART care. This challenge is huge in clients identified through active index testing. In the sub–Saharan African, less than one third of those identified are linked to care and for those that are linked in care less than three quarters of them continue to be in care Despite the 2016 universal treatment policy, Malawi is still facing the challenges where clients identified through AIT are taking time and some do not show up in the facilities to engage in care. There is limited data on strategies for optimising uptake and retention of AIT clients in care to achieve suppression which may reduce mortality and morbidity rates due to HIV/AIDS.
Objectives of the study
Broad objective 1. To explore factors that influence uptake and retention in ART care and treatment among clients diagnosed HIV positive through Active Index Testing in Dedza Malawi.
Specific objectives 1. To investigate facilitators to initiate and remain in ART care and treatment among HIV clients diagnosed through index testing. 2. To identify potential strategies that can facilitate ART initiation and retention in care among clients diagnosed through index clients and 3. To identify differentiated service delivery models of care to improve linkage and retention in ART care among clients diagnosed HIV positive through AIT.
Methodology The study setting will be Dedza, Malawi in three health facilities that are currently implementing Active index testing. The health facilities are Mtendere, Mua, and Dedza district Hospital. The study population will be contacts of index clients (18 years of age and above) who can willingly consent and are HIV positive diagnosed through Active index testing. In addition, ART providers and expert clients who have been providing ART for not less than 12 months will also be
Commented [CMM1]: Citation removed
Commented [CMM2]: Citation removed
Commented [CMM3]: Objectives in executive summary put in bullets and indicated as broad and specific objectives
15-Jul-2021
Exploration of factors to increase uptake and retention in ART care among AIT client’s version 2.0, 25 June 2021
4
approached and asked to participate in the study. Hence 10 ART providers, 10 expert clients and 20 contacts of indexes that have been diagnosed HIV positive through Active index testing will be asked to participate in the study.
The study will employ maximum variation purposive sampling to study participants from all angles for better understanding of the topic and to achieve heterogeneity. Index clients’ registers in the three facilities will be used to identify contacts who tested positive. All contacts aged 18 and above who can consent and were tested HIV positive regardless of whether they initiated or did not initiate ART care will be earmarked to be enrolled after consenting to participate. While certified ART providers and known expert clients that have been working at the facility for not less than 12 months and are willing to participate will be asked to take part in the study.
Semi structured in-depth interviews will be conducted for data collection. The interviews will be recorded, transcribed and translated into English for analysis. The PI will do the analysis where coding themes will be developed. Social Ecological Model will guide analysis of data in this study.
Expected findings and dissemination Study findings will help health workers to identify barriers and influencers of clients identified HIV positive through active index testing to linkage and continuation in treatment. It will also guide policy makers to come up with targeted interventions to close existing gaps on index testing program across the HIV cascade. Research findings will be disseminated at COMREC and Dedza District Health Office. In addition, the research findings will be disseminated at local and international conferences and manuscripts of results will be submitted for publication in peer reviewed journals
15
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Research Subject Categories::MEDICINE