Factors associated with late Human Immunodeficiency Virus (HIV) diagnosis among peoples living with it, Northwest Ethiopia: hospital based unmatched case-control study

Abstract

BackgroundEarly HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy.MethodsInstitution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count <350cells/mm3 or WHO clinical stage III and IV regardless of the CD4 count at first presentation and controls were those who had CD4 count ≥350cells/mm3 or WHO clinical stage I and II. If both criteria were available, the CD4 count was used in the study as World Health Organization recommended. A total of 392 respondents (196 cases and 196 controls) were recruited and selected systematically. The data were collected by trained nurses using chart review and interviewer administered structured questionnaire. Binary Logistic Regression Model was used to identify the factors associated with late HIV diagnosis.ResultsAbout 95.9 % of study participants provided complete response. Having no understanding, compared to having understanding, about HIV/AIDS (AOR = 1.7, 95 %CI = 1.08–2.79) and ART (AOR = 2.1, 95 %CI: 1.25–3.72), being tested as a result of symptoms/ illness, compared to being tested for risk exposure (inverted AOR =2.5, 95 %CI: 1.64–4.76), and acquiring HIV through sexual contact, compared to acquiring it through other modes (AOR = 2.5, 95 %CI = 1.52–4.76) were positively and independently associated with late HIV diagnosis.ConclusionsUnlike perceived HIV stigma, having no understanding about HIV and ART, being tested for presence of symptoms/illness, and acquiring HIV through sexual contact were independent and significant factors for late HIV diagnosis.

Factors Associated With Late Presentation to HIV Care Among Patients Attending in Public Hospitals of Mekelle City, Tigray, Ethiopia, 2018/19. Case- Control Study.

“…In this study, presence of chronic illness was significantly associated with late presentation to HIV care. This finding is in line with the study conducted in Ethiopia, Bahirdar (7).This could be similar in characteristics, accessing health service .But this result is lower than the study conducted in Canada (15).This diference could be diference in time of study, study population and sample size.…”

“…(6).As one of the sub-Saharan country the case in Ethiopia is not different, in 2016, there were 720,000 people living with HIV and 27,104 newly diagnosed cases. But only 67% of expected PLWH know their status and 59% of them were enrolled in highly active antiretroviral therapy (HAART) program, while significant proportion people living with HIV were died (7).…”

Socio-demographic, clinical and health facility-related predictors of delayed HIV diagnosis among patients newly diagnosed with HIV in Northwest Ethiopia: a multilevel analysis

“…Baseline clinical pro les of patients such as poor functional status and presented having symptoms at rst HIV diagnosis were associated with delayed HIV diagnosis, which was similar to previous reports [5,15,[29][30][31]. Strengthening existing HIV testing programs including healthcare provider-initiated HIV testing and counseling services should be improved.…”

“…Late presentation to care may occur even though the patients are aware of the HIV status due to several reasons such as fear of stigma [25]. In addition to this, many previously published studies [15,31,32] used a small sample size, were single-site study, used secondary data, and were carried out before test and treat strategy was implemented. So that whether or not test and treat strategy improved HIV test uptake and avoid delayed HIV diagnosis was examined.…”

“My Friend with HIV Remains a Friend”: HIV/AIDS Stigma Reduction through Education in Secondary Schools—A Pilot Project in Buea, Cameroon

“…Respondents who had high perceived HIV stigma, as compared to those who had low perceived HIV stigma, were 1.7 times more likely to be diagnosed (adjusted odds ratio ¼ 1.7, 95% CI: 1-2.89), which is similar with the result of a case-control study in South Wollo, Northeast Ethiopia. 34,35 According to our data, the majority of the health-care workers, social workers, or other PLWHIV were however supportive or very supportive when they interacted with the interviewee. 20 This information together with the ICRW tool kit helped us build the curriculum that our teachers used in working with the students.…”