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282 Client Retention in HIV/AIDS Research in Africa
G. Bhat*1,2, V. Bwalya2, D. Jones3, S. Weiss3, J. Campbell1, and B. Hojer4
1Sch. of Med., Univ. of Zambia; 2Univ. Teaching Hosp. (UTH), Lusaka, Zambia; 3Univ. of Miami Sch. of Med., FL, USA; and 4Karolinska Inst., Stockholm, Sweden
Background: Client retention is crucial in HIV/AIDS prevention and treatment research. We hereby describe our experience in client retention from our 2 ongoing intervention studies.
Methods: In Study “A” which offered same day HIV voluntary counselling and testing (VCT), using rapid HIV assays for women attending regular prenatal clinics in Lusaka, we provided result-specific post-test counselling and condoms during the same visit. All HIV-positive and -negative women were asked to come back for follow-up. Women who did not come back for follow-up were visited at their homes by nurse-midwives, who provided counselling, or by the community health workers. In Study “B” 75 HIV-positive and 75 HIV-negative women were provided with barrier methods of HIV prevention devices (male and female condoms and microbicide preparations) and were followed up only at the UTH. Women who were recruited and followed up from Community Health Centres (CHCs) were compared with those from UTH and reasons for low follow-up were analysed.
Results: In Study “A” 483 and 229 women were recruited from 2 CHCs and UTH, respectively. Follow-up rate at the CHCs (65.4%) was significantly higher than at the UTH (35.8%) (p < 0.001). This was again proved by low follow-up rate (49.3%) at the UTH in Study B. Clients preferred CHCs and were reluctant to come to the UTH; they also did not like home visits.
Conclusions: Community-based studies have higher client retention compared with hospital-based studies. Home visits are associated with HIV-related stigma.
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