"i Pray that they accept me without scolding

" Experiences with disengagement and re-engagement in HIV care and treatment services in Tanzania

Erica H. Layer, Heena Brahmbhatt, Sarah Beckham, Jacob Ntogwisangu, Ard Mwampashi, Wendy W. Davis, Deanna Kerrigan, Caitlin E Kennedy

Research output: Contribution to journalArticle

Abstract

HIV care and treatment programs in sub-Saharan Africa have been remarkably successful, but disengagement from care by people living with HIV (PLHIV) remains high. The goal of this study was to explore the experiences of PLHIV who disengaged from HIV care in Iringa, Tanzania. We conducted a series of three longitudinal, semi-structured interviews with 14 PLHIV who had disengaged from ART programs for a total of 37 interviews. Narrative analysis was used to identify key themes. Our findings indicate that an individual's decision to disengage from care often resulted from harsh and disrespectful treatment from providers following missed appointments. Once disengaged, participants reported a strong desire to re-engage in care but also reluctance to return due to fear of further mistreatment. Participants who successfully re-engaged in care during the course of this study leveraged social support networks to facilitate this process, but often felt guilt and shame for breaking clinic rules and believed themselves to be at fault for disengagement. Developing strategies to minimize disengagement and facilitate re-engagement through more flexible attendance policies, improved client-provider interactions, and outreach and support for disengaged clients could increase retention and re-engagement in HIV care and treatment programs.

Original languageEnglish (US)
Pages (from-to)483-488
Number of pages6
JournalAIDS Patient Care and STDs
Volume28
Issue number9
DOIs
StatePublished - Sep 1 2014

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Tanzania
HIV
Social Support
Interviews
Shame
Guilt
Africa South of the Sahara
Fear
Appointments and Schedules

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

"i Pray that they accept me without scolding : " Experiences with disengagement and re-engagement in HIV care and treatment services in Tanzania. / Layer, Erica H.; Brahmbhatt, Heena; Beckham, Sarah; Ntogwisangu, Jacob; Mwampashi, Ard; Davis, Wendy W.; Kerrigan, Deanna; Kennedy, Caitlin E.

In: AIDS Patient Care and STDs, Vol. 28, No. 9, 01.09.2014, p. 483-488.

Research output: Contribution to journalArticle

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