Multi-Level Factors Affecting Entry into and Engagement in the HIV Continuum of Care in Iringa, Tanzania

Multi-Level Factors Affecting Entry into and Engagement in the HIV Continuum of Care in Iringa, Tanzania

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0104961

Progression through the HIV continuum of care is critical to the success of HIV treatment and prevention efforts. However, significant losses occur at each stage of the continuum and little is known about contextual factors contributing to disengagement at these stages.

This study explores multi-level barriers that influence entry into and engagement in the continuum of care in Iringa, Tanzania.

Key barriers include

  • the reluctance to engage in HIV services while healthy
  • rigid clinic policies
  • disrespectful treatment from service providers
  • stockouts of supplies
  • stigma and discrimination
  • alternate healing systems
  • distance to health facilities
  • poverty

The study illustrates how multiple barriers interact and influence decisions about engagement in care. It stresses that barriers at multiple levels need to be addressed, in order to to promote increased engagement and retention in care.

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