Correlates of missed HIV appointments in low-resource settings: a study from Uganda

Abstract

Aims: Alarming reports of antiretroviral treatment failure have recently emerged in sub-Saharan Africa. The onset of virologic failure has multiple causes but suboptimal treatment adherence is one of the leading causes. This study aimed to explore correlates of adherence to HIV appointments in community care patients living with HIV/AIDS in Uganda. Methods: Two hundred and ninety-five people living with HIV (median age 37.0 years; interquartile range 16.0; female 67.8% [n = 200]) reported whether they had missed any of their four-weekly appointments during the past 24 weeks. They also completed the Internalized AIDS-Related Stigma Scale, Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, the Alcohol-Use Disorders Identification Test, and the Physical Activity Vital Sign. Results: Thirty-three (11.2%) patients missed at least one of their six scheduled appointments in the 24-week period. The adjusted odds ratio for missing at least one of six appointments was 3.03 (95% CI: 1.21–8.43, p = 0.01) for those who were physically inactive, and 2.29 (95% CI: 0.93–5.63, p = 0.046) for those with depression. Conclusions: Targeting future rehabilitation studies for PLHIV around feelings of depression and around physical inactivity could be important in achieving optimal HIV treatment adherence.