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Understanding why HIV-infected persons disengaged from pre-ART care in Freetown, Sierra Leone: a qualitative study

Kelly JD, Hickey MD, Schlough GW, Conteh S, Sesay M, Rutherford GW, Giordano TP, Weiser SD. Understanding why HIV-infected persons disengaged from pre-ART care in Freetown, Sierra Leone: a qualitative study. AIDS Care. 2019 Apr 1; 31(4):494-497.

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Abstract:

In countries that have not implemented universal antiretroviral treatment (ART), loss to follow-up (LTFU) during pre-ART care remains a problem. We conducted semi-structured interviews with 41 HIV-infected persons who were LTFU during pre-ART care from a prospective cohort of persons newly diagnosed with HIV infection in Freetown, Sierra Leone, in 2012-2013. Interviews determined whether the participant disengaged or transferred care and explored the reasons for being LTFU. Of the 41 participants, 34 (83%) disengaged from care. For persons who disengaged from care, socioeconomic barriers emerged as a dominant theme in both ART-eligible and -ineligible groups while psychosocial barriers emerged as a dominant theme in the ART-ineligible group. Structural barriers emerged as a dominant theme for participants who transferred care. Interventions designed to address socioeconomic and psychosocial barriers may help reduce disengagement from pre-ART care.




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