Willingness and Feasibility of Using Injectable Antiretroviral Therapy among Women who Retained and Disengaged from Prevention of Mother to Child HIV Transmission Programs in Uganda

Award amount: 30,000.00

One-third of women who initiate or continue antiretroviral treatment (ART) during pregnancy are lost to follow up with in six months [1, 2]. ART tablets and pill containers a potential for HIV status disclosure and stigma [1-4] which has stimulated interest in alternate modes of administration including long-acting injections [3, 5] Willingness to use injectable antiretroviral therapy (ART) among women in prevention of mother-to-child transmission (PMTCT) programs in Uganda is unknown.

The main aim of this study is to assess the factors, perceptions and motivations associated with injectable ART use among PMTCT participants retained and those who have disengaged from care.

Aims

1. To explore the willingness, fears and potential barriers of women in PMTCT programs to using long-acting injectable (LART)

2. To explore the willingness, fears, concerns and potential barriers of health workers in delivering LART to PMTCT women

3. To establish the readiness of PMTCT programs to support LART

Methods:

The study will employ a mixed methods approach of data collection. Population: 1) Women attending PMTCT clinics, women disengaged from PMTCT clinics, 2) health workers, 3) Policy makers from the Ministry of Health. Data will be collected through In-depth interviews, focus group discussions and observation. A Reach, Effectiveness, Adoption, Implementation, maintenance (REAIM) evaluation framework of acceptability and feasibility will be adopted in measuring health facility readiness [6].

A total of 7 health facilities will be selected purposively from IDI Mulago clinic and KCCA clinics: Kisenyi, Komamboga, Kisaw, Kawaala, Kitebi HC IIIs because of the high-volume PMTCT clinics and Makerere University John Hopkins university because it is currently assessing injectable ART.

Women retained in care will purposively be identified from the PMTCT clinics or through the national HIV electronic medical records system. A woman will be categorized as retained if she had at least one clinic encounter within their scheduled visit. A woman will be classified as disengaged if she had no clinic encounter within 90 days from the scheduled visit. Data will be checked for completeness before the participant leaves. Data will be coded and entered into electronic database. data will be cleaned and descriptive statistics such as proportions, means and medians, wherever applicable will be done. Data displayed in tables and graphs will be used in measuring feasibility. Qualitative analysis will be conducted using a thematic approach with the aid of Nvivo software.