Factors Contributing to Antiretroviral Therapy Discontinuation at Patrice Lumumba Health Centre: A Retrospective Cross-Sectional Study

Abstract

Introduction: Human Immunodeficiency Virus (HIV) infection is a major global public health challenge, with Sub-Saharan Africa, including Mozambique, bearing the greatest burden. Adherence to antiretroviral therapy (ART) is essential for viral suppression, reducing mortality, and preventing new infections. Yet discontinuation to ART persists due to complex social, economic, and structural factors. Local evidence is critical to inform targeted interventions for retention in care. This study assessed the determinants of ART discontinuation among patients receiving follow-up care at Patrice Lumumba Health Centre in Xai-Xai City, Gaza Province, Mozambique. Methodology: A retrospective cross-sectional study was conducted for all 134 patients who discontinued ART between 2017 and 2021, from a total of 2,067 patients on antiretroviral therapy. Treatment discontinuation was considered as failure to collect ART for over two months in accordance with the Mozambique Ministry of Health guidelines. This study employed purposive sampling to collect data from clinical records of patients who discontinued antiretroviral treatment (ART) at Patrice Lumumba Health Centre between 2017 and 2021. The data was entered in Excel and analyzed using SPSS version 28, and presented using descriptive statistics. Results: Discontinuation was most frequent among women (100, 74.6%) and young adults aged 21–31 years (58, 43%). Peaks occurred in 2019 (39,29%) and 2021 (35,26%). Most participants (n =78, 0.5 km) lived near the health facility, with the Patrice Lumumba Administrative Post. Underrepresentation of participants from distant areas suggests that proximity to the health facility influences access to services. Nutritional patterns were generally adequate, with (114, 85.1%) reporting three daily meals. Discontinuation was a multifactorial phenomenon shaped by social, economic, cultural, and organizational factors rather than single isolated determinants. Conclusions: ART discontinuation at Patrice Lumumba Health Centre is driven by intersecting social, economic, cultural, and structural factors, with young women being particularly vulnerable. Targeted interventions, including psychosocial support, active follow-up, flexible clinic schedules, and community-based service delivery, are recommended to improve retention and adherence.