Background Loss to follow-up (LTFU) from care among people living with HIV (PLHIV) is thought to be more common in the public setting compared to the private health care. It is anticipated that the problem may become worse with the current “test and treat” policy in Uganda due to the likely increases in patient loads and its attendant pressure on health care providers to support patient counseling. This study determined the incidence and factors associated with LTFU from HIV care among adult PLHIV in public health facilities in Wakiso district, Uganda. Methods This was a retrospective cohort study that involved the review of 646 records of patients initiated on antiretroviral therapy (ART) between January 1st, 2015 and December 31st, 2017 at 13 randomly selected public health facilities in Wakiso district. The cox proportional hazards regression was used to determine the factors associated with LTFU. The results were supported by sequential in-depth and key informant interviews to explore reasons for LTFU. Results Of the 646 patients enrolled, 391 were female (60.5%), 282 were below 30 years (43.6%) and 207 were married (50.1%). A total of 216 patients (33.4%) had no documented outcomes and were considered LTFU. The incidence of LTFU was 21 per 1000 person months (95% confidence interval (CI): 18–25 per 1000 person months). Factors associated with LTFU included having normal weight compared to underweight (adjusted hazard ratio (aHR) 0.64, 95% CI: 0.45–0.90, p = 0.011), receiving HIV care from hospitals compared to lower level facilities (aHR 0.22, 95% CI: 0.12–0.41, p < 0.001), and no telephone contact compared to those with a telephone contact (aHR 2.16, 95% CI: 1.33–3.51, p = 0.002). Stigmatization and long waiting times were the prominent reasons for LTFU reported from the in-depth and key informant interviews. Conclusions The incidence of LTFU in public health facilities in Uganda is quite high and is associated with being underweight, not having a telephone contact to receive reminders and receiving care at lower level facilities. Early diagnosis, routine use of patient address locator forms and improved quality of HIV care at lower level health facilities may reduce LTFU among PLHIV. Electronic supplementary material The online version of this article (10.1186/s12913-019-4474-6) contains supplementary material, which is available to authorized users.

The conservation of chimpanzees (Pan troglodytes) faces complex and dynamic threats, deriving mostly from anthropogenic factors such as high density and poverty in local human populations. One specific threat is poaching, which contributes to both permanent physical disabilities in chimpanzees and cross-species disease transmission. In the Sonso chimpanzee community, Budongo forest, Uganda, over 20% chimpanzees are permanently disabled by indiscriminate poachers' snare-trap. While severe injuries can sometimes result in death, little is known about the long-term health impacts of poaching to chimpanzees or possible effective mitigation measures. To combat and monitor the complexities of conservation threats, a holistic transdisciplinary approach is required and as a result, the Budongo Conservation Field Station (BCFS) has implemented a comprehensive strategy. Instead of focusing solely on chimpanzee health, our multi-faced tit-for-tat approach also incorporates education and action measures for local communities living adjacent to the forest. To reduce poaching, we provide alternative livelihood sources, veterinary services and education while concurrently employing their local indigenous knowledge of poaching practices to more effectively locate snares/traps in the forest. To mitigate disease transmission across species, beneficiaries in incentive programs must have functional sanitation facilities. To consistently monitor threats and conservation impacts, we routinely collect data on snare recovery and infectious disease prevalence in chimpanzees, humans and livestock. Our preliminary results, since the programs' inception, show a reduction in respiratory and gastro-intestinal infections coupled with an increase in snare recovery from the forest. These findings suggest that our holistic approach is effective in mitigating the threats to chimpanzees in Budongo forest.PeerJ Preprints | https://doi.org/10.7287/peerj.preprints.1848v1 | CC-BY 4.0

The conservation of chimpanzees (Pan troglodytes) faces complex and dynamic threats, deriving mostly from anthropogenic factors such as high density and poverty in local human populations. One specific threat is poaching, which contributes to both permanent physical disabilities in chimpanzees and cross-species disease transmission. In the Sonso chimpanzee community, Budongo forest, Uganda, over 20% chimpanzees are permanently disabled by indiscriminate poachers’ snare-trap. While severe injuries can sometimes result in death, little is known about the long-term health impacts of poaching to chimpanzees or possible effective mitigation measures. To combat and monitor the complexities of conservation threats, a holistic transdisciplinary approach is required and as a result, the Budongo Conservation Field Station (BCFS) has implemented a comprehensive strategy. Instead of focusing solely on chimpanzee health, our multi-faced tit-for-tat approach also incorporates education and action measures for local communities living adjacent to the forest. To reduce poaching, we provide alternative livelihood sources, veterinary services and education while concurrently employing their local indigenous knowledge of poaching practices to more effectively locate snares/traps in the forest. To mitigate disease transmission across species, beneficiaries in incentive programs must have functional sanitation facilities. To consistently monitor threats and conservation impacts, we routinely collect data on snare recovery and infectious disease prevalence in chimpanzees, humans and livestock. Our preliminary results, since the programs’ inception, show a reduction in respiratory and gastrointestinal infections coupled with an increase in snare recovery from the forest. These findings suggest that our holistic approach is effective in mitigating the threats to chimpanzees in Budongo forest.

Mobility is linked to negative HIV care continuum outcomes. We sought to understand factors associated with short and long term mobility among women in fishing communities in Kenya, Tanzania, and Uganda. From 2018 through 2019 we conducted a cross-sectional survey of women aged 15 years and above, randomly selected from a census of six fishing villages, around Lake Victoria. Data collected included: demographics, risky sexual behaviour on the most recent trip, and travel behaviour in the previous 4 months. Mobility was recorded as any overnight trip outside the participant’s village. A two-level multinomial logistic regression model was used to determine the associated factors. A total of 901 participants were enrolled, of whom 645 (71.6%) reported travelling (53.4%; short and 18.2% long term trips). Five factors were associated with long term travel: age, travel purpose, frequency of travel, sexual behaviour while travelling, and destination. Trips made by women aged 46–75 years were less likely to be long term. Long term trips were more common if the trip was to visit, rather than to trade, and more common for women who reported one or two trips rather than three or more trips. Women who made long term trips were more likely to engage in unprotected sex while on a trip. Women who travelled to a regional town/district or another town/district were more likely to take long term trips. The factors associated with travel duration among women living in fishing communities could inform planning of future health care interventions in these communities.