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. 2025 Apr 22:15:100653.
doi: 10.1016/j.ijregi.2025.100653. eCollection 2025 Jun.

Incidence and predictors of loss to follow-up among South Sudanese refugees with HIV receiving care in Adjumani District, Uganda

Christopher Nyolonga  1 , Joshua Uchaki Ufoyrwoth  1 , Trinity Wanok  1 , David Komakech  1 , Joseph Baruch Baluku  2 , Felix Bongomin  1   3
Affiliations

Incidence and predictors of loss to follow-up among South Sudanese refugees with HIV receiving care in Adjumani District, Uganda

Christopher Nyolonga et al. IJID Reg. .

Abstract

Objectives: HIV care pose a significant challenge in refugee population. We determined the incidence and predictors of loss to follow-up (LTFU) among South Sudanese refugees with HIV in Uganda.

Methods: We conducted a retrospective cohort study in public health facilities in Adjumani District, Uganda, involving South Sudanese refugees with HIV. LTFU was defined as missing 3 or more consecutive months at any point in their care since the start of the study period. A Cox proportional hazards regression analysis was fitted to determine independent predictors of LTFU and results are presented as adjusted hazard ratios (aHRs) with corresponding 95% confidence intervals (CIs).

Results: We included data of 449 participants, with a median age of 37 (interquartile range: 30-43) years. Most were female patients (75.5%, n = 339) receiving care from health center (HC) III (87.3%, n = 392), with baseline World Health Organization stage 1 (79.3%, n = 341), negative baseline tuberculosis status (89.1%, n = 302), and suppressed viral load (86.5%, n = 360) and had no co-morbidity (91%, n = 402). Overall, 25 (5.6%) were lost to follow-up. Factors independently associated with LTFU were being male (aHR: 2.6, 95% CI: 1.1-6.1, P = 0.03) and receiving care from HC IV (aHR: 3.0, 95% CI: 1.0-8.8, P = 0.04).

Conclusions: LTFU among South Sudanese refugees with HIV in Uganda is substantial. Routine use of patient address locator forms, and improved quality of HIV care at HC IV and men-targeted outreaches and community involvement may reduce LTFU among refugees living with HIV.

Keywords: HIV; Living with HIV; Loss to follow-up; Refugees.

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Conflict of interest statement

The authors have no competing interests to declare.

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References

    1. UNAIDS . UNAIDS; 2024. Global HIV & AIDS statistics — fact sheet. [accessed 17 September 2024]

    2. https://www.unaids.org/en/resources/fact-sheet.

    1. Uganda Misnistry of Health . UPHIA; Kampala, Uganda: 2022. Uganda Population-based HIV Impact Assessment; Uphia summary sheet 2020-2021.
    1. Office of Prime Minister Republic of Uganda (OPM). Top countries of origin of refugees in Uganda, https://opm.go.ug/refugees/#:∼:text=Refugees; 2019 [accessed 14 April 2025].
    1. United Nations Higher Commissioner for Refugees (UNHCR) Kampala, Uganda; 2023. Uganda Population Dashboard: Overview of Refugees and Asylum-seekers in Uganda.
    1. UPHIA . UPHIA; Kampala, Uganda: 2021. Uganda refugee population-based hiv impact assessment Ruphia 2021 response rates and HIV testing.

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