Factors associated with late presentation for HIV/AIDS care in Harare City, Zimbabwe, 2015

Nyika, Howard; Mugurungi, Owen; Shambira, Gerald; Gombe, Notion Tafara; Bangure, Donewell; Mungati, More; Tshimanga, Mufuta

doi:10.1186/s12889-016-3044-7

Cited by 27 publications

(57 citation statements)

References 19 publications

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“…Nearly 60 % of the patients in our study were delayed presenters, a finding that is similar with a study conducted in Zimbabwe [38]. This is also a comparable magnitude with DP of general HIV population in Africa [22, 26]. …”

Section: Discussionsupporting

confidence: 90%

“…In Africa, 35–65 % report late for HIV care [22–25]. Reported barriers to DP among general population have include several factors including: age, sex, level of education, income, place of residence, perceiving HIV as curable, HIV related stigma, co-morbidity, having contact with female sex workers, alcohol users, chewing chat, smoking cigarette, perceived risky sexual behaviour, pre-and post-test counseling [4, 15, 20, 21, 26, 27]. …”

Section: Introductionmentioning

confidence: 99%

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The prevalence and associated factors for delayed presentation for HIV care among tuberculosis/HIV co-infected patients in Southwest Ethiopia: a retrospective observational cohort

et al. 2016

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BackgroundA delay presentation for human immunodeficiency virus (HIV) patient’s care (that is late engagement to HIV care due to delayed HIV testing or delayed linkage for HIV care after the diagnosis of HIV positive) is a critical step in the series of HIV patient care continuum. In Ethiopia, delayed presentation (DP) for HIV care among vulnerable groups such as tuberculosis (Tb) /HIV co-infected patients has not been assessed. We aimed to assess the prevalence of and factors associated with DP (CD4 < 200 cells/μl at first visit) among Tb/HIV co-infected patients in southwest Ethiopia.MethodsA retrospective observational cohort study collated Tb/HIV data from Jimma University Teaching Hospital for the period of September 2010 and August 2012. The data analysis used logistic regression model at P value of ≤ 0.05 in the final model.ResultsThe prevalence of DP among Tb/HIV co-infected patients was 59.9 %. Tb/HIV co-infected patients who had a house with at least two rooms were less likely (AOR, 0.5; 95 % CI: 0.3–1.0) to present late than those having only single room. Tobacco non-users of Tb/HIV co-infected participants were also 50 % less likely (AOR, 0.5; 95 % CI: 0.3–0.8) to present late for HIV care compared to tobacco users. The relative odds of DP among Tb/HIV co-infected patients with ambulatory (AOR, 1.8; 95 % CI, 1.0–3.1) and bedridden (AOR, 8.3; 95 % CI, 2.8–25.1) functional status was higher than with working status.ConclusionsThree out of five Tb/HIV co-infected patients presented late for HIV care. Higher proportions of DP were observed in bedridden patients, tobacco smokers, and those who had a single room residence. These findings have intervention implications and call for effective management strategies for Tb/HIV co-infection including early HIV diagnosis and early linkage to HIV care services.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0193-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The prevalence and associated factors for delayed presentation for HIV care among tuberculosis/HIV co-infected patients in Southwest Ethiopia: a retrospective observational cohort

et al. 2016

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“…The extracted data included specific details about the exposure, populations, study methods and outcomes of significance to the review question and specific objectives. Corresponding authors of two studies[ 40 , 41 ] were communicated via e-mail and asked to fill a prepared two by two contingency table in word consisting of numbers of PLHIV perceiving high and low HIV related stigma in row, and numbers of PLHIV presented late and early to HIV care in a column. However, only author of one study[ 40 ] replied the request.…”

Section: Methods and Participantsmentioning

confidence: 99%

Significant association between perceived HIV related stigma and late presentation for HIV/AIDS care in low and middle-income countries: A systematic review and meta-analysis

et al. 2017

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BackgroundLate presentation for human immunodeficiency virus (HIV) care is a major impediment for the success of antiretroviral therapy (ART) outcomes. The role that stigma plays as a potential barrier to timely diagnosis and treatment of HIV among people living with HIV/AIDS (acquired immunodeficiency syndrome) is ambivalent. This review aimed to assess the best available evidence regarding the association between perceived HIV related stigma and time to present for HIV/AIDS care.MethodsQuantitative studies conducted in English language between 2002 and 2016 that evaluated the association between HIV related stigma and late presentation for HIV care were sought across four major databases. This review considered studies that included the following outcome: ‘late HIV testing’, ‘late HIV diagnosis’ and ‘late presentation for HIV care after testing’. Data were extracted using a standardized Joanna Briggs Institute (JBI) data extraction tool. Meta- analysis was undertaken using Revman-5 software. I2 and chi-square test were used to assess heterogeneity. Summary statistics were expressed as pooled odds ratio with 95% confidence intervals and corresponding p-value.ResultsTen studies from low- and middle- income countries met the search criteria, including six (6) and four (4) case control studies and cross-sectional studies respectively. The total sample size in the included studies was 3,788 participants. Half (5) of the studies reported a significant association between stigma and late presentation for HIV care. The meta-analytical association showed that people who perceived high HIV related stigma had two times more probability of late presentation for HIV care than who perceived low stigma (pooled odds ratio = 2.4; 95%CI: 1.6–3.6, I2 = 79%).ConclusionsHigh perceptions of HIV related stigma influenced timely presentation for HIV care. In order to avoid late HIV care presentation due the fear of stigma among patients, health professionals should play a key role in informing and counselling patients on the benefits of early HIV testing or early entry to HIV care. Additionally, linking the systems and positive case tracing after HIV testing should be strengthened.

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“…Demographic, behavioural and clinical factors contributed for LP [ 6 , 20 , 28 , 29 ]. For instance, being female, older age, rural dwellers, alcohol users, ‘ Khat ’ chewers, cigarette smokers, being diagnosed with sever co-morbidities, perceiving HIV related stigma, having contact with commercial sex workers and being exposed to risky sexual behavior were the factors associated with LP [ 6 , 20 , 28 , 29 ]. In Ethiopia, other studies have assessed factors affecting LP [ 6 , 27 , 29 ], and all except one were from the northern part of the country.…”

Section: Introductionmentioning

confidence: 99%

Late presentation for HIV care in Southwest Ethiopia in 2003–2015: prevalence, trend, outcomes and risk factors

et al. 2018

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BackgroundEarly presentation for HIV care is vital as an initial tread in the UNAIDS 90–90–90 targets. However, late presentation for HIV care (LP) challenges achieving the targets. This study assessed the prevalence, trends, outcomes and risk factorsfor LP.MethodsA 12 year retrospective cohort study was conducted using electronic medical records extracted from an antiretroviral therapy (ART) clinic at Jimma University Teaching Hospital. LP for children refers to moderate or severe immune-suppression, or WHO clinical stage 3 or 4 at the time of first presentation to the ART clinics. LP for adults refers to CD4 lymphocyte count of < 200 cells/ μl and < 350 cells/μl irrespective of clinical staging, or WHO clinical stage 3 or 4 irrespective of CD4 count at the time of first presentation to the ART clinics. Binary logistic regression was used to identify factors that were associated with LP, and missing data were handled using multiple imputations.ResultsThree hundred ninety-nine children and 4900 adults were enrolled in ART care between 2003 and 15. The prevalence of LP was 57% in children and 66.7% in adults with an overall prevalence of 65.5%, and the 10-year analysis of LP showed upward trends. 57% of dead children, 32% of discontinued children, and 97% of children with immunological failure were late presenters for HIV care. Similarly, 65% of dead adults, 65% of discontinued adults, and 79% of adults with immunological failure presented late for the care. Age between 25- < 50 years (AOR = 0.4,95% CI:0.3–0.6) and 50+ years (AOR = 0.4,95% CI:0.2–0.6), being female (AOR = 1.2, 95% CI: 1.03–1.5), having Tb/HIV co-infection (AOR = 1.6, 95% CI: 1.09–2.1), having no previous history of HIV testing (AOR = 1.2, 95% CI: 1.1–1.4), and HIV care enrollment period in 2012 and after (AOR = 0.8, 95% CI: 0.7–0.9) were the factors associated with LP for Adults. For children, none of the factors were associated with LP.ConclusionsThe prevalence of LP was high in both adults and children. The majority of both children and adults who presented late for HIV care had died and developed immunological failure. Effective programs should be designed and implemented to tackle the gap in timely HIV care engagement.

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Factors associated with late presentation for HIV/AIDS care in Harare City, Zimbabwe, 2015

Cited by 27 publications

References 19 publications

The prevalence and associated factors for delayed presentation for HIV care among tuberculosis/HIV co-infected patients in Southwest Ethiopia: a retrospective observational cohort

The prevalence and associated factors for delayed presentation for HIV care among tuberculosis/HIV co-infected patients in Southwest Ethiopia: a retrospective observational cohort

Significant association between perceived HIV related stigma and late presentation for HIV/AIDS care in low and middle-income countries: A systematic review and meta-analysis

Late presentation for HIV care in Southwest Ethiopia in 2003–2015: prevalence, trend, outcomes and risk factors

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