Determinants of uptake of “test and treat” among HIV positive patients in Pallisa district

Abstract

The Eastern region of Uganda currently holds the lowest HIV viral suppression rate in the country. Pallisa, among other districts in the region, struggles to attain the 95% HIV viral suppression target recommended under the new World Health Organization guidelines. It is well established that enrolling patients for Test and Treat not only reduces the risk of HIV transmission but also increases the rate of HIV viral suppression. This study aimed to examine the determinants of Uptake of Test and Treat among HIV/AIDS positive patients in Pallisa district. Secondary data on 233 HIV/AIDS positive patients in a cohort study in Pallisa hospital were obtained from Health Management Information System. The analysis was done using the Mantel- Haenszel chi square, to test for the homogeneity of the odds ratio, and the complementary log regression model. The Mantel – Haenszel test for the overall effect of the covariate on uptake of Test and Treat across all strata revealed that Co-infection with Tuberculosis and residence had a significant effect on uptake of Test and Treat (M-H Chi2 (2) =13.29, p=0.0003, M-H Chi2 (2) =3.54, p=0.000). In the multivariate analysis, using the complementary log regression, the study revealed older patients( =0.942,p=0.001), patients with higher baseline CD4 ( =0.998,p=0.025) and those whose entry points into care were Medical Outpatient and PMTCT ( = 0.182,p= 0.000, =0.241,p=0.013) were less likely to uptake Test and treat, while HIV Patients coinfected with Tuberculosis were more likely to uptake Test ( =38.441,p=0.000) and Treat than those without Tuberculosis. Patient age, Baseline CD4, Care entry Point and Co-infection with Tuberculosis were the determinants of uptake of test and treat among HIV positive patients in Pallisa District. The study recommends strong follow ups on patients diagnosed with HIV in older age and those with high baseline CD4 on immediate uptake on test and treat since they’re less likely to uptake of test and treat in Pallisa District.