Facilitators and barriers to linkage to HIV care and treatment among female sex workers in a community-based HIV prevention intervention in Tanzania: A qualitative study

Nyato, Daniel; Nnko, Soori; Komba, Albert; Kuringe, Evodius; Plotkin, Marya; Mbita, Gaspar; Shao, Amani; Changalucha, John; Wambura, Mwita

doi:10.1371/journal.pone.0219032

Cited by 33 publications

(29 citation statements)

References 38 publications

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“…26,27 Poor ART uptake due to distance in rural areas has been reported in other studies, 9,28 besides the limitations relating to healthcare infrastructures, eg, where there is no privacy and or a shortage of voluntary counselling and testing services. 29,31 Availability of alternative care providers, especially in rural settings, is another limiting factor for ART uptake in many countries in SSA. 29 For instance, one study done in rural Tanzania reported the preference for traditional medicine as a major barrier to ART in children.…”

Section: Discussionmentioning

confidence: 99%

<p>Correlates of Uptake of Antiretroviral Therapy in HIV-Positive Orphans and Vulnerable Children Aged 0–14 Years in Tanzania</p>

Exavery¹,

Charles²,

Kuhlik³

et al. 2020

HIV

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Background: In 2018, only 65% of Tanzanian children aged 0-14 years living with human immunodeficiency virus (HIV) were on treatment, suggesting that challenges exist. This study explores factors associated with uptake of antiretroviral therapy (ART) among HIV-positive orphans and vulnerable children (OVC). Methods: Data are from the USAID Kizazi Kipya project that aims to increase the uptake of HIV/AIDS and other health and social services by OVC and their caregivers. HIV-positive OVC aged 0-14 years who were enrolled in the project from January 2017 to September 2018 were analyzed. ART status (off ART or on ART) was the outcome variable. Multivariate analysis was performed using multilevel logistic regression. Results: Of the 10,047 HIV-positive OVC aged 0-14 years analyzed, 93.5% were currently on ART at enrollment. In the multivariate analysis, OVC with male caregivers were 4-times more likely than those with female caregivers to be on ART (OR=4.03, 95% CI=1.49-10.90). OVC with HIV-positive caregivers were 12-times more likely than those with HIV-negative caregivers to be on ART (OR=12.0, 95% CI=3.81-37.70). OVC with caregivers who did not disclose their HIV status were 74% less likely to be on ART than OVC of HIV-negative caregivers (OR=0.26, 95% CI=0.08-0.90). OVC living in urban areas were more than 5-times as likely as their rural counterparts to be on ART (OR=5.55, 95% CI=2.21-14.0). Conclusion: The majority of the OVCLHIV in the current study were currently on ART (93.5%) at enrollment. However, uptake of ART by the OVC was dependent on factors external to themselves. Advancing ART uptake may require targeting OVC of female caregivers, OVC of HIV-negative caregivers, as well as OVC of caregivers of undisclosed HIV statu, and rural areas.

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Section: Discussionmentioning

confidence: 99%

<p>Correlates of Uptake of Antiretroviral Therapy in HIV-Positive Orphans and Vulnerable Children Aged 0–14 Years in Tanzania</p>

Exavery¹,

Charles²,

Kuhlik³

et al. 2020

HIV

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“…In turn both material access getting to the clinic (e.g. transport, distance, cost) [37,38] and psychosocial dynamics within the clinic (e.g. how groups do or do not feel respected and well-treated) will both be important issues to attend to as LA ART rolls-out across distinct settings [37][38][39][40][41].…”

Section: Plos Onementioning

confidence: 99%

“…transport, distance, cost) [37,38] and psychosocial dynamics within the clinic (e.g. how groups do or do not feel respected and well-treated) will both be important issues to attend to as LA ART rolls-out across distinct settings [37][38][39][40][41]. These factors are also known barriers to retention in care and adherence to daily oral ART, [42][43][44] suggesting that while LA ART will alleviate many challenges to adherence, there will still be ongoing and important issues to attend to in order to optimize HIV outcomes [45].…”

Section: Plos Onementioning

confidence: 99%

“A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania

et al. 2020

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Background Long-acting injectable antiretroviral therapy (LA ART) was found to be non-inferior to daily oral ART in Phase 3 clinical trials. LA ART may offer an important alternative for people living with HIV with challenges adhering to daily oral ART or preferences for non-pill-based regimens. Methods Using a mixed methods approach integrating survey, in-depth interview and biological data from female sex workers (FSW) living with HIV in Tanzania (N = 208) and the Dominican Republic (DR) (N = 201), we assessed factors associated with the potential likelihood of LA ART use if it were available. We conducted multivariate logistic regression and thematic content analysis. Results Likelihood of LA ART use was high with 84.92% of FSW from the DR and 92.27% of FSW from Tanzania reporting they would be "likely" or "very likely" to use LA ART if available (p = 0.02). In Tanzania better HIV-related patient-provider communication (AOR 4.58; 95% CI 1.90-11.05) and quality of HIV clinical care (AOR 3.68; 95% CI 1.05-12.86) were positively

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“…In an effort to effort to address the HIV self-testing research gap in Tanzania for heterosexual men, the Tanzania Self-Testing Education and Promotion (Tanzania STEP) project for men was launched in 2018 [32]. Since then, the Government of Tanzania also started a national HIV self-testing demonstration project focused on men who have sex with men and female sex workers (FSWs) as part of Sauti (meaning "voice of the people"), a ve-year implementation science community-based HIV prevention program funded by the U.S. President's Emergency Plan for AIDS Relief and U.S. Agency for International Development (PEPFAR/USAID) [33,34]. The overall aim of the Tanzania STEP and national HIV selftesting demonstration projects was to generate country-speci c data on the implementation models, uptake, feasibility and acceptability HIV self-testing in order to inform policy development and future implementation and scale-up of HIV self-testing in Tanzania.…”

Section: Introductionmentioning

confidence: 99%

Men’s Comfort to Distribute or Receive HIV Self-Test Kits from Close Male Social Network Members in Tanzania: Baseline Results from the STEP Project

Matovu

Mbita

Hamilton

et al. 2021

Preprint

Self Cite

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Background Few studies have explored alternative strategies for reaching men with HIV self-testing services. In this study, we assessed the factors associated with men’s comfort to distribute or receive HIV self-test kits from close male friends among men who socialize in networks locally referred to as "camps" in Tanzania. Methods Data are from a cluster-randomized controlled trial conducted in June 2019 in 18 social networks or “camps” in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. Robust Poisson regression was implemented through the generalized random effect model with the log link to assess the factors associated with being comfortable to receive and/or give out HIV self-test kits to close male members within one’s social network. Results Of 505 participants, 67.9% (n = 342) reported that they would be comfortable giving HIV self-test kits to close male friends while 68.2% (n = 344) were comfortable receiving HIV self-test kits from their close male friends. Ever having heard about HIV self-testing (Adjusted Prevalence Rate (Adj. PR): 1.6; 95% Confidence Interval [CI]: 1.3, 1.9), willingness to self-test for HIV in front of a sexual partner (Adj. PR: 3.0; 95%CI: 1.5, 6.1) and exposure to peer-led HIV self-testing education and promotion (Adj. PR: 1.4; 95%CI: 1.2, 1.7) were significantly associated with being comfortable to receive and/or give out HIV self-test kits to close male members within one’s social network. Conclusions Prior awareness of HIV self-testing, willingness to self-test before one’s sexual partner and exposure to peer-led HIV self-testing education and promotion were significantly associated with being comfortable to give or receive HIV self-test kits from close male friends in this population. These findings suggest that distribution of HIV self-test kits through close male friends could improve the proportion of men reached with HIV self-testing services and improve HIV testing rates in this population where uptake remains low.

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Facilitators and barriers to linkage to HIV care and treatment among female sex workers in a community-based HIV prevention intervention in Tanzania: A qualitative study

Cited by 33 publications

References 38 publications

<p>Correlates of Uptake of Antiretroviral Therapy in HIV-Positive Orphans and Vulnerable Children Aged 0–14 Years in Tanzania</p>

<p>Correlates of Uptake of Antiretroviral Therapy in HIV-Positive Orphans and Vulnerable Children Aged 0–14 Years in Tanzania</p>

“A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania

Men’s Comfort to Distribute or Receive HIV Self-Test Kits from Close Male Social Network Members in Tanzania: Baseline Results from the STEP Project

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