Browsing by Author "Centa,Boniface G."

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    Outcome evaluation of differentiated HIV testing services in improving linkage of newly diagnosed clients to care and treatment in selected health facilities in Morogoro Region
    (Mzumbe University, 2025) Centa,Boniface G.
    Background: Linkage to HIV care and treatment following diagnosis is essential for the prompt initiation of antiretroviral therapy and for effective epidemic control. The NASHCoP 2022-2026 Strategic Plan aims to achieve 100% linkage rate. This evaluation assessed the effectiveness of Differentiated HIV Testing Services and contextual factors influencing linkage to care and treatment among newly HIV clients in Morogoro region from January 2024 to February 2025. Methods: A sequential explanatory mixed-methods was used. Quantitatively, a multistage sample of 392 newly diagnosed clients was drawn from facility records. Data on the linkage proportion, timeliness, and associated factors were analysed using descriptive statistics and a logistic regression in STATA v17.0. Qualitatively purposively selected 6 healthcare providers who provide HTS at various testing points were interviewed in-depth; transcripts underwent phenomenological analysis in ATLAS.ti v9 to identify facilitators and barriers of linkage to care. Results: Of the newly diagnosed clients, 90.05% were successfully linked to care, with 95% of those linked being enrolled on the same day of diagnosis. Higher odds of successful linkage were observed among females (AOR=7.19; P=0.014), and those diagnosed at dispensaries (AOR=2.10; P=0.017). Qualitative findings identified key facilitators including high quality pre and post-test counseling, positive provider-client relationships, active phone follow-up, support from expert clients and mentor mothers, and weekly departmental meetings. Major barriers included cultural denial among Maasai pastoralist communities, religious beliefs, unavailability of CTC services on weekends, stigma and distance to CTC. Conclusion: Linkage to HIV care was high but below universal targets, with same day enrolment common. Success was influenced by gender, marital status, distance, and contact availability, proper counseling, and peer support. Persistent cultural, religious, and stigma-related barriers require targeted interventions