P17.22 Providers’ perceptions of the causes of loss to follow-up of hiv-infected children in botswana

Introduction Healthcare providers (nurses, physicians, and social workers), by virtue of their experiences in interacting with HIV-infected children and their caregivers, are an important source of information on the causes of loss to follow-up (LTFU). We explored perceptions of healthcare providers regarding factors that lead to paediatric HIV-infected patients becoming lost to follow-up from care and treatment. Methods The study was conducted at a large paediatric HIV clinic in Gaborone, Botswana and involved conducting in-depth interviews with clinical staff (n = 10). The interviews targeted information about the magnitude of LTFU problems and possible solutions as perceived by the healthcare providers. Results Respondents perceived factors of LTFU to include issues of HIV-related stigma, caregiver’s religious beliefs of being healed, teenage-child rebellion, and concerns about disclosure of their HIV status to others, were characteristic of the patients LTFU. The results also revealed that mental health issues such as depression might not be adequately addressed in HIV clinic settings, perceived as a key underlying factor of LTFU. Conclusion Our study underscores the psychosocial nature of the issues of LTFU and the need to develop a more holistic approach to treating HIV-infected children. Disclosure of interest statement Funding for this study was made possible through Fogarty International Centre of the National Institutes of Health, (M. W. Kline – Principal Investigator) under grant number D43 TW01036.