Mageda, KihulyaKulemba, KhamisKapologwe, NtuliKatalambula, LeonardPetrucka, Pammla2023-05-252023-05-252023Mageda, K., Kulemba, K., Kapologwe, N., Katalambula, L., & Petrucka, P. (2023). Factors associated with low antiretroviral therapy enrollment of children in the Simiyu region: A cross-sectional Creswell mixed-methods sequential explanatory design. Medicine, 102(14).URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10082253/http://hdl.handle.net/20.500.12661/3979Full text article. Also available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10082253/Despite substantial antiretroviral therapy (ART) coverage in other groups with the human immunodeficiency virus (HIV) in Tanzania, there is a progressive decline in ART enrolment among HIV-infected children. This study aimed to determine the factors affecting the enrolment of children with HIV in ART and to identify an effective, sustainable intervention to address children’s ART care enrolment. To achieve this, we conducted a cross-sectional study using a mixed-method sequential explanatory design, including children with HIV aged 2 to 14 years in the Simiyu region. Stata™ and NVIVO™ software were used to perform quantitative and qualitative data analyses, respectively. In the quantitative analyses, we considered 427 children, with a mean age of 8.54 ± 3.54 years and a median age of 3 years (interquartile range: 1–6 years). The mean length of ART initiation delay was 3.71 ± 3.21 years. Additionally, independent child enrolment predictors included distance to the facility (adjusted odds ratio [AOR]: 3.31; 95% confidence interval [CI]:1.14–9.58), caregivers’ income (AOR: 0.17; 95% CI: 0.07–0.43), and fear of stigma (AOR: 3.43; 95% CI: 1.14–10.35). In qualitative analyses, 36 respondents reported that stigma, distance, and lack of HIV-positive status disclosure to their fathers were causes for low enrolment in ART. Overall, this study demonstrated that a caregiver’s income, distance to obtain HIV care services, HIV-positive status non-disclosure to the father, and fear of stigma played a significant role in children’s enrolment in HIV care. As such, HIV/acquired immunodeficiency syndrome programs would benefit from having intensive interventions to address distance, such as scaling up care and treatment centers, as well as techniques to reduce stigma in the population.enHIV enrollmentChildren enrollmentAntiretroviral therapyARTHIV-infected childrenHuman immunodeficiency virusART initiationSimiyu regionChildrenTherapyRetroviral therapyHIVArticle