| dc.description.abstract |
Globally, approximately one-in-four people living with HIV (PLHIV) experiences interrup-tion in treatment (IIT), risking viral rebound, transmission, morbidity, and mortality.Murang’a County reported 82% viral suppression coverage, below Kenya’s 94%. Thisstudy assessed IIT magnitude and determinants using sequential-explanatory mixedmethods across nine high-volume facilities (Jan 2023–Jun 2024). PLHIV missing clinicalappointments by >30 days were compared with those retained using descriptive statis-tics, chi-square, and logistic regression. Among 11,472 PLHIV, 6.5% (742) experienced IIT;50.8% (377) did not return to care. IIT was associated with age 20–24 (aRR =2.02), 25–49years (aRR = 2.27), male (aRR = 1.42), viral non-suppression (aRR = 6.35), invalid viral load(aRR = 9.59), ART duration 6–12 months (aRR = 4.96), and WHO stages 3&4 (aRR = 2.08)(All p < 0.001). Focus group discussions revealed HIV undetectable VL equals untransmit-table knowledge gaps, negative service experiences, transport costs, long waits, fre-quent clinic visits, pill burden, stigma, and prayers replacing ART barriers. PLHIV with IITexperienced prolonged care disengagement, with higher rates among younger PLHIV,men, those with unsuppressed and older VL, early ART, and advanced HIV disease, influenced by individual, healthcare systems, treatment-related, and sociocultural barriers.Strengthening early tracing, differentiated service delivery, longer-acting ART, VL moni-toring adherence, HIV literacy, and stigma reduction is critical to improving retention. |
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