Background: Human immune deficiency virus (HIV) remains the leading cause of morbidity and mortality globally. It can lead to AIDS, which results in gradual deterioration and failure of the immune system. As the immune system becomes compromised, the patient becomes highly susceptible to life-threatening infection which ends with early death. Even though antiretroviral therapy (ART) significantly decreases mortality as a whole, the rate of death is still the highest, especially in the first and second years of ART initiation. Objectives: To assess the survival and predictors of mortality among HIV-infected adults after initiation of anti-retroviral therapy in Jigjiga Governmental Hospitals, Eastern Ethiopia. Method: Institution-based Retrospective follow-up study was employed among ART patients from January 1, 2015, to December 31, 2021. Data were cleaned and entered in Epi-data version 3.1 and exported to STATA 14 for further analysis. Kaplan–Meier and Log-Rank tests were applied to compare survival differences among categories of different variables. In bi-variable analysis, p-values < 0.20 were included in a multivariable analysis. A multivariate Cox regression model was used to measure the risk of death & identify the significant predictors of death. Variables that p-value < 0.05 were considered statistically significant predictors of mortality. Result in this study 466(53.34%) participants were male and 552(65.56 %) were urban residents about 91(10.81%) have died with an overall incidence rate of 3.92 (95% CI (2.4–5.4)) per 100-person year of observation. The overall survival probability of the study group was 83.97%. In the multivariable Cox regression analysis, baseline WHO stage III/IV (AHR=2.42(1.43-4.09)) have no caregiver (AHR=2.23; 95% CI (1.16-4.29)), being bedridden functional status (AHR=2.18; 95% CI (1.01-4.72)), and poor last known adherence level (AHR=4.23; 95%CI (2.39-7.47)) were found to be significant predictors of mortality. Conclusion: the incidence of death was relatively high, especially in the second year of ART start. Baseline clinical WHO stage Ⅲ/Ⅳ, bedridden functional status at enrolment, and absence of caregiver, poor level of recent adherence was found to be independent predictors of mortality. Patients with these risk factors need special attention and are crucial to reducing the rate of mortality.

Background: Lost to follow-up (LTFU) among patients on antiretroviral therapy accounts for the most of all attrition. In Sub-Saharan Africa,there is a concern regarding high rates of LTFU and early mortality in antiretroviral therapy programs. Mortality and transferred out are the potential competing events for LTFU. Ignoring these events may give an invalid estimate by overestimating the probability of the occurrence of LTFU. Objective: This study aims to assess the incidence and predictors of LTFU among adult HIV (Human Immunodeficiency Virus) patients who started antiretroviral therapy (ART) in Jigjiga Governmental Hospitals’ ART clinics between January 2015 and December 2021. Methods: A multi-center Institution-based retrospective follow-up study has been conducted in Jigjiga Governmental Hospitals. Gray’s test was used to compare the cumulative incidence function (CIF) of LTFU across variable categories. A graphical examination of CIF for each category of variables, as well as the Schoenfeld residuals global test, validate the proportional sub-hazard assumption. We fitted both univariable and multivariable competing risk regression models. In the multivariable analysis, variables with p-values of 0.05 were considered statistically significant predictors of LTFU. Result: A total of 842 clients were included in the study, and the LTFU incidence rate is 5.25 per 100 PYO. The participants’ median age ranged from 29 to 43 years. Those not disclosed their HIV status (aSHR=4.22; 95%CI (2.11-8.47)), those were a fair and poor level of recent adherence (aSHR=2.17; 95%CI (1.18-4.23)) and (aSHR=1.48; 95%CI (2.97-5.34)), patients with severe anemia (aSHR 4.58; 95% CI (1.28-16.39)) ambulatory functional status (aSHR 2.38; 95% CI (1.21-4.68)), patients who do not took cotrimoxazole prophylactic therapy (CPT) (aSHR 2.47; 95% CI (2.99-6.15)) were significant predictors of LTFU. Conclusion: In this study, the incidence of LTFU was decreased with additional years on ART. Patients on ART who did not disclose their HIV status had poor levels of adherence, did not take CPT prophylaxis, on severe anemia and ambulatory functional status were at higher risk of LTFU. As a result, close monitoring and proper tracing mechanisms aimed at this higher-risk group would reduce AIDS (Acquired immunodeficiency syndrome)-related LTFU.