Project: Antiretroviral therapy Outcomes, Barriers and facilitators of Adherence among individuals initiating Treatment following Test and Start guidelines in an urban HIV clinic in Uganda

Acronym	ABOUT (Reference Number: TMA2016CDF-1602)
Duration	01/06/2018 - 31/05/2021
Project Topic	Background: Recent World Health Organization (WHO) guidelines recommend antiretroviral therapy (ART) initiation for everyone diagnosed with HIV regardless of CD4+ cell count and pre-exposure prophylaxis for those at substantial risk of HIV infection. However, there are fears that initiating healthy people on treatment may instead result in poor treatment outcomes due to non-adherence. We seek to assess treatment outcomes, barriers and facilitators of adherence and linkage to care among individuals initiating antiretroviral therapy (ART) under “Test and Start” guidelines in an urban HIV clinic in Uganda. Methods: This will be a mixed methods study using both qualitative and quantitative methods. The quantitative study will involve a retrospective analysis of medical records of all HIV-positive individuals (>18 years) initiated on ART under “Test and Start” at Kawaala Health Centre III between January 2017 and January 2018 followed up over two years. Participants’ longitudinal data on socio-demographic characteristics, adherence, CD4 counts, viral loads (VLs), opportunistic infections and patient retention at 6, 12 and 24 months on ART will be abstracted. We shall describe proportion of participants with viral suppression (VL =1000 copies/mL), mean adherence using selfreports, incidence of opportunistic infections, mortality rates, retention in care rates at 6, 12 and 24months. Analysis will include descriptive statistics, chi-square and t-tests and survival analysis using STATA® software to estimate time to viral suppression (VL =1000 copies/mL). Survival analysis will be used to analyse the data with STATA® software to estimate time to viral suppression (VL =1000 copies/mL). In order to assess barriers and facilitators for adherence to ART, a purposively selected sample of 24 individuals will participate in In-depth Interviews (IDIs). Participants will be classified as adherers if they reported adherence =95% with corresponding viral suppression. Non-adherers will be categorized as irregular (inconsistent or reporting adherence
Network	EDCTP2
Call	Career Development Fellowships 2016

Project partner

Number	Name	Role	Country
1	Infectious Diseases Institute Limited	Coordinator	Uganda