Factors Associated with Linkage to HIV Care Among Oral Self-Tested HIV Positive Adults in Uganda

Figures & data

Table 1 Socio-Demographic Characteristics of the Study Participants

Characteristics and their Categories	All Participants n=144 n (%) or Mean (SD)	Linked to ART n=100 n (%) or Mean (SD)	Not-Linked to ART n=44 n (%) or Mean (SD)	p-value
Age (years)
18–25	64 (45)	39 (61)	25 (39)	0.021
26–30	34 (24)	23 (68)	11 (32)
31–35	22 (15)	16 (73)	6 (27)
36–40	10 (7)	9 (90)	1 (10)
41–60	13 (9)	12 (92)	1(8)
Sex
Female	104 (72)	68 (68)	36 (82)	0.088
Male	40 (28)	32 (32)	8 (18)
Key population groups
FSW	63 (43)	27 (43)	36 (57)	<0.001
GP	64 (44)	63 (98) 2	1 (2)
MSM	9 (6)	2 (22)	7 (78)
MTA	8 (5)	8 (100)	0
Education level
No formal education	11 (8)	5 (45)	6 (55)	0.207
Primary	48 (33)	35 (73)	13 (27)
Secondary/vocational	81 (56)	58 (72)	23 (28)
Higher education	4 (3)	2 (50)	2 (50)
Able to read
Yes	127 (88)	90 (81)	37 (84)	0.311
No	17 (12)	10 (10)	7 (16)
Religion
Anglican	29 (20)	20 (69)	9 (31)	0.934
Catholic	52 (36)	36 (69)	16 (31)
Seventh-day	3 (2)	3 (100)	0
Saved/Pentecostal	16 (12)	12 (71)	5 (29)
Moslem	42 (29)	28 (67)	14 (33)
Marital status
Married	39 (27)	37 (95)	2 (5)	<0.001
Single (never married)	77 (54)	47 (61)	30 (39)
Separated/divorced	23 (16)	13 (57)	10 (43)
Widowed	5 (3)	3 (60)	2 (40)
Have children
Yes	105 (73)	76 (72)	29 (28)	0.209
No	39 (27)	24 (62)	15 (38)
Income status (UGX)
<50,000	39 (27)	31 (79)	8 (21)	0.180
50–100,000	38 (26)	23 (61)	15 (39)
100–350,000	51 (36)	37 (73)	14 (27)
350–500,000	10 (7)	6 (60)	4 (40)
>500,000/=	5 (4)	2 (40)	3 (60)
Consume alcohol
Yes	55 (38)	33 (60)	22 (40)	0.053
No	89 (62)	67 (75)	22 (25)
Time on takes to hospital (minutes)
1–20	24 (17)	12 (50)	12 (50)	<0.001
21–40	63 (44)	40 (63)	23 (37)
41–60	49 (35)	40 (82)	9 (18)
Above 60	6 (4)	6 (100)	0
Means of transport
Walking	35 (24)	18 (51)	17 (49)	0.024
Boda-Boda,	73 (51)	52 (71)	21 (29)
Taxi (Matatu)	35 (24)	29 (83)	6 (17)
Public bus	1 (1)	1 (100)	0
Cost of transport (UGX)
<5000	97 (67)	61 (63)	36 (37)	0.019
6000 to 15,000	38 (26)	30 (79)	8 (21)
More than 15,000	9 (6)	9 (100)	0
Quality of health care received
Very good	52 (36)	49 (94)	3 (6)	<0.001
Good	82 (57)	47 (57)	35 (43)
Not good	9 (7)	4 (44)	5 (56)

Note: The bold font was used to show statistically significant p-values (p < 0.05).

Abbreviations: FSW, female sex worker; GP, general population; MSM, men who have sex with men; MTA, men through Antenatal care; UGX, Ugandan Shilling; ART, antiretroviral therapy.

Table 2 Health-Related Characteristics of the Study Participants

Characteristics and their Categories	All Participants n=144 n (%)	Linked to ART n=100 n (%)	Not-Linked to ART n=44 n (%)	p-value
Health status
Poor health	26 (18)	18 (69)	8 (31)	0.873
Good health	113 (78)	79 (70)	34 (30)
Excellent health	5 (4)	3 (60)	2 (40)
HIVST kits distribution point
Community	131 (91)	91 (69)	40 (31)	0.986
Health facility	13 (9)	9 (69)	4 (31)
Type of HIVST
Directly assisted	66 (46)	62 (94)	4 (6)	<0.001
Unassisted	78 (54)	38 (49)	40 (51)
Denial of HIVST results
Yes	90 (65)	63 (70)	27 (30)	0.490
No	49 (35)	37 (76)	12 (24)
Knowledge of anyone taking ART at home
Yes	61 (42)	44 (72)	17 (28)	0.196
No	72 (50)	51 (71)	21 (29)
I do not know	11 (8)	5 (45)	6 (55)
Know of ART side effects
Yes	78 (54)	59 (76)	19 (24)	0.020
No	49 (34)	34 (69)	15 (31)
I do not know	17 (12)	7 (41)	10 (59)
Likely to get ART side effects
Not likely	55 (38)	52 (95)	3 (5)	<0.001
Somewhat likely	22 (15)	15 (68)	7 (32)
Very likely	34 (24)	23 (68)	11 (32)
I do not know	33 (23)	10 (30)	23 (70)
Received HIV counselling
Yes	135 (94)	99 (73)	36 (27)	<0.001
No	9 (6)	1 (11)	8 (89)
Disclosed to the sexual partner
Yes	84 (59)	65 (77)	19 (23)	0.011
No	58 (40)	34 (59)	24 (41)
I do not want to	1 (1)	0	1 (100)
Disclosed to family/friend
Yes	102 (71)	75 (74)	27 (26)	0.001
No	36 (25)	25 (69)	11 (31)
I do not want to	6 (4)	0	6 (100)
Thought of being treated unfairly if disclosed to partner /family
Not likely	68 (47)	57 (84)	11 (16)	<0.001
Somehow likely	30 (21)	23 (77)	7 (23)
Very likely	30 (21)	15 (50)	15 (50)
I do not know	16 (11)	5 (31)	11 (69)
Ready to start ART
Very ready	62 (43)	50 (81)	12 (19)	<0.001
Ready	42 (29)	33 (79)	9 (21)
Not ready	40 (28)	17 (42)	23 (58)

Note: The bold font was used to show statistically significant p-values (p < 0.05).

Abbreviations: STD, sexually transmitted diseases; ART, antiretroviral therapy.

Table 3 Factors Associated with Linkage to HIV Care at Bivariate and Multivariate Analysis

Characteristics and Categories	Unadjusted Prevalence Rate-Ratio (95% CI)	p-value	Adjusted Prevalence Rate-Ratio (95% CI)	p-value
Age (years)
<25	1.0		1.0
26–30	1.11 (0.82–1.51)	0.502	1.13 (0.89–1.45)	0.333
31–35	1.19 (0.86–1.65)	0.284	1.39(1.06–1.84)	0.019
36–40	1.48(1.11-1.97)	0.008	1.36(0.96–1.93)	0.079
41–60	1.52(1.18-1.95)	0.001	1.46(1.06-2.00)	0.022
Sex
Male	1.0		1.0
Female	0.82 (0.66–1.01)	0.059	0.82 (0.68–0.99)	0.044
Education level
No formal education	1.0
Primary	1.6 (0.82–3.14)	0.168
Secondary/vocational	1.58 (0.81–3.06)	0.180
Higher education	1.1 (0.34–3.57)	0.874
Type of HIV self-testing
Unassisted HIVST	1.0
Directly assisted HIVST	1.93 (1.52–2.44)	<0.001
Marital status
Married	1.0
Single (never married)	0.64(0.53-0.78)	<0.001
Separated/divorced	0.59(0.41-0.86)	0.006
Widowed	0.63(0.31-1.30)	0.214
Have children
No	1.0
Yes	1.18 (0.89–1.55)	0.249
Work time
Throughout the year	1.0		1.0
Seasonally	1.67 (1.34–2.06)	<0.001	1.1 (0.9–1.33)	0.355
Once in a while	1.31 (0.98–1.77)	0.073	1.23 (0.98–1.55)	0.079
Income status (UGX)
<50,000	1.0
50,001–100,000	0.76 (0.56–1.03)	0.078
100,001–350,000	0.91(0.72-1.15)	0.442
350–500,000	0.75(0.44-1.29)	0.301
>500,000	0.50(0.17-1.49)	0.217
Drinking alcohol
Yes	1.0		1.0
No	1.25 (0.98–1.61)	0.072	1.26 (1.04–1.53)	0.019
Decision about health care
Myself	1.0
Partner	1.46(1.30-1.65)	<0.001
Myself and my partner	0.98(0.43-2.19)	0.955
My parents/guardian	1.13(0.82-1.55)	0.466
Travel time to a health facility
<20 minutes	1.0		1.0
21–40 minutes	1.27(0.82-1.98)	0.291	1.28(0.88-1.87)	0.202
41–60 minutes	1.63 (1.07–2.49)	0.023	1.27(0.88-1.83)	0.210
61–120 minutes	2.0 (1.34–2.99)	0.001	1.41(0.98-2.04)	0.065
Time to HIV confirmatory test
Same day	1.0
Within a week	1.09(0.91-1.31)	0.369
>a week	0.88(0.69-1.12)	0.302
Do not remember	0.25(0.07-0.87)	0.029
Received counselling
No	1.0		1.0
Yes	6.6 (1.03–42.28)	0.046	5.36 (0.93–30.87)	0.06
Disclosed to partner
No	1.0
Yes	1.32 (1.03–1.69)	0.027
Thought of being treated unfairly if disclosed
Not likely	1.0		1.0
Somehow likely	0.91 (0.73–1.14)	0.435	1.1 (0.87–1.34)	0.486
Very likely	0.59 (0.41–0.86)	0.007	0.67 (0.46–0.97)	0.032
I do not know	0.37 (0.18–0.78)	0.009	0.51 (0.28–0.92)	0.025
Readiness to start ART
Not ready	1.0
Ready	1.85 (1.25–2.74)	0.002
Very ready	1.89 (1.29–2.78)	0.001
Knowledge of ART side effects
No	1.0
Yes	1.09 (0.87–1.37)	0.453
I do not know	0.59 (0.32–1.08)	0.088
Likely to get ART side effects
Not likely	1.0		1.0
Somewhat likely	0.72 (0.54–0.97)	0.029	0.71 (0.54–0.95)	0.018
Very likely	0.72 (0.56–0.91)	0.007	0.80 (0.64–1.01)	0.056
I do not know	0.32 (0.19–0.54)	<0.001	0.42 (0.26–0.68	<0.001
Means of transport
Walking	1.0		1.0
Boda-boda	1.39 (0.97–1.97)	0.072	1.33 (0.95–1.84)	0.093
Taxi (Matatu)	1.61 (1.13–2.30)	0.009	1.31 (0.94–1.84)	0.114
Quality of health care services
Not good	1.0
Good	1.29 (0.61–2.75)	0.510
Very good	2.12 (1.02–4.43)	0.045

Notes: 1=reference category; the bold font was used to show statistically significant p-values (p < 0.05).

Abbreviations: CI, confidence interval; ART, antiretroviral therapy.