Factors associated with uptake of community client-led ART delivery model at Mulago adult HIV clinic _ Mulago National Referral Hospital

Abstract

Community Client Led ART Delivery (CCLAD) model in Uganda refers to self-formed groups of six to eight stable Anti Retro viral Therapy (ART) patients from the same community or area. Members go in turn for medication refill for all members of the group. As this reduces facility visit burden for each patient, this model of care shows greater impact in terms of access and coverage. To identify factors associated with the uptake of CCLAD model at Mulago Adult HIV clinic between May andJune, 2019,descriptive as well as analytical cross-sectional design were used, both quantitative and qualitative in nature. Random sample of 246 patients was used. Questionnaire, focus group discussion guide and interview guide were used for data collection. Uptake of CCLAD model was 10%, which is lower than the national uptake (17%). Uptake was associated with health-care worker and individual-related factors like having no concerns about getting their ARVs from the community (COR = 5.5, AOR = 6.1, p = 0.002) and having the component of CCLAD model in the education talks (COR = 2.1, AOR = 2.1, p = 0.000), among other associated factors. Qualitative interviews affirmed these findings. Implementation of this model requires interventions like health education talks and prompt referrals of clients to the model.