title: Factors associated with access to HIV care services in eastern Uganda: the Kumi home based HIV counseling and testing program experience.
abstract: BACKGROUND
  The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. Approximately 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4-1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000-81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The aim of this study therefore, was to explore the factors associated with access to HIV care services among HIV seropositive clients identified by a home based HIV counseling and testing program in Kumi district, eastern Uganda.
  
  
  METHODS
  In a cross sectional study conducted in February 2009, we explored predictor variables: socio-demographics, health facility and community factors related to access to HIV care and treatment. The main outcome measure was reported receipt of cotrimoxazole for prophylaxis.
  
  
  RESULTS
  The majority [81.1 % (284/350)] of respondents received cotrimoxazole prophylaxis (indicating access to HIV care). The main factors associated with access to HIV care include; age 25-34 years (AOR = 5.1, 95 % CI: 1.5-17.1), male sex (AOR = 2.3, 95 % CI: 1.2-4.4), urban residence (AOR = 2.5, CI: 1.1-5.9) and lack of family support (AOR = 0.5, CI: 0.2-0.9).
  
  
  CONCLUSIONS
  There was relatively high access to HIV care and treatment services at health facilities for HIV positive clients referred from the Kumi home based HIV counseling and testing program. The factors associated with access to HIV care services include; age group, sex, residence and having a supportive family. Stakeholders involved in providing HIV care and treatment services in similar settings should therefore consider these socio-demographic variables as they formulate interventions to improve access to HIV care services.
authors.affiliation: Department of Community Health and Behavioural Sciences, Makerere University, College of Health Sciences, School of Public Health, P.O.Box 7072, Kampala, Uganda. Lubogodad@yahoo.com.
authors.forename: David
authors.initials: D
authors.lastname: Lubogo
authors.affiliation: Department of Disease Control and Environmental Health, Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda. jddamulira@musph.ac.ug.
authors.forename: John Bosco
authors.initials: JB
authors.lastname: Ddamulira
authors.affiliation: Department of Health Policy Planning and Management, Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda. rtweheyo@musph.ac.ug.
authors.forename: Raymond
authors.initials: R
authors.lastname: Tweheyo
authors.affiliation: Department of Community Health and Behavioural Sciences, Makerere University, College of Health Sciences, School of Public Health, P.O.Box 7072, Kampala, Uganda. hwamani@musph.ac.ug.
authors.forename: Henry
authors.initials: H
authors.lastname: Wamani
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003376:Counseling / Q000458:organization & administration; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control; D012737:Sex Factors; D011795:Surveys and Questionnaires; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014454:Uganda; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination