Term of Award

Spring 2023

Degree Name

Doctor of Public Health in Community Health Behavior and Education (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Health Policy and Community Health

Committee Chair

Gulzar Shah

Committee Member 1

Stacy Smallwood

Committee Member 2

Dziyana Nazaruk

Committee Member 3

Kristie Waterfield

Committee Member 3 Email



Background: Patients living with HIV (PLHIV) often face challenges that contribute to missed clinical care which can impact their health outcomes.

Purpose: The primary objective of this study was to examine associations of clinical and sociodemographic factors such as age at the entrance into antiretroviral treatment (ART), rurality-urbanicity, biological sex, province of residence, and viral load with PLHIV’s tendency to miss scheduled visits for ART among persons living with HIV (PLHIV) in the Kinshasa and Haut-Katanga provinces of the Democratic Republic of Congo (DRC) between 2018 and 2019.

Methods: The study participants for this quantitative study were 5338 adults living with HIV who received ART for 12 months, from July 2018 to June 2019. Descriptive statistics was computed to show the level of missed appointments for ART. Associations of clinical and sociodemographic factors with tendency to miss scheduled visits were estimated using multivariable logistic regression analysis.

Results: 329(6%) PLHIV experienced at least one missed visit while 5009 (94%) experienced no missed visits. PLHIV that had a viral load > or equal to 1000 copies/ml (20%) were a small proportion of the study participants. Those that were from semi-rural (76%) were a greater proportion of the study participants compared to rural (18%) and urban (6%), and regarding age, older PLHIV > or equal to 18 years (89%) were a greater proportion of the study participants Chi-Squaretests of association showed that of the variables analyzed, only Rural-Urban and Age at start of ART had a statistically significant relationship with missed visit (P=

Conclusion: The findings from this study strongly suggest that there is a significant association between certain demographic factors, age and rurality-urbanicity and missed visits. The study findings have implications for policy and interventions targeting PLHIV at higher risk of missed visits.


Research Data and Supplementary Material