| dc.description.abstract | Globally, HIV/AIDS remains a major public health concern, with about 22 million people receiving lifelong antiretroviral therapy, for which retention on care is essential for optimal clinical outcomes, particularly in reducing HIV-related morbidity and mortality, incidence of new infections, and antiretroviral drug resistance development. In Homa Bay, community health volunteers (CHVs) who had been trained on Home and Community Based Care (HCBC) are providing support to people living with HIV (PLHIVs) and are on antiretroviral therapy (ART) to improve adherence and retention on care. At the time of the study, retention was 75% against the expected 100%. There was no documented evidence to show retention among PLHIVs attached to HCBC trained CHVs. This study assessed the influence of the training on retention and associated factors in Rachuonyo North Sub County, Homa Bay County. A total of 100 CHVs, 290 PLHIVs, and 2 key informants were enrolled for interviews, and data on retention extracted from patient files records and reports at the CCC. Quantitative data was summarized using descriptive statistics, while inferrential analysis was used to detect the association between CHV and PLHIV characteristics and PLHIV retention (a=0.05). Qualitative data was thematically analyzed, and findings triangulated with results from quantitative data analysis. The overall retention of PLHIVs in the selected 8 high-volume facilities in Rachuonyo North Sub county was 86%, and the retention among PLHIVs attached to HCBC-trained CHVs was 100%, while the PLHIVs not attached were retained at 83%. The PLHIV attached to trained CHVs were 6.5 times more likely to be retained on care than those not attached, while PLHIVs who had been on ART for 5-14 years were likely to adhere to ART compared to those who had been on care for less than 5 years (p=0.013). There was no significant relationship between retention on care and income level, viremia, or comorbidities among the PLHIVs (p> 0.05). The study found that ART retention was 3 times likely to reduce among PLHIVs attached to CHVs of the opposite sex. The study did not find any association between ART retention and age of CHVs. In addition, CHVs trained on HCBC were 0.08 times (COR: 0.57, AOR: 0.49) more likely to influence PLHIV adherence to ART than those not trained. The study recommends that; the Ministry of Health, through NASCOP and other partners, should consider supporting the attachment of PLHIVs to HCBC-trained CHVs to sustain the observed high retention, the MoH should enhance the support to newly-enrolled PLHIVs to boost their retention levels on ART and care, and that in attaching the PLHIVs to CHVs, it is advised that Ministry of Health officers concerned ensure same gender pairing, to improve adherence and retention on care. | en_US |