Predictors of Late HIV Diagnosis among People Living with HIV in Adare and Yirgalem General Hospitals, SNNPR, Ethiopia: A Case Control Study

Alemayehu, Akalewold (2014) Predictors of Late HIV Diagnosis among People Living with HIV in Adare and Yirgalem General Hospitals, SNNPR, Ethiopia: A Case Control Study. Masters thesis, Addis Ababa University.

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Abstract

Introduction: Even if early diagnosis, access to treatment and ensuring people living with HIV to receive ongoing care and treatment is one of the most effective ways to prevent the further spread of HIV and to protect the health of those living with the virus, lack of knowledge of HIV status is a major barrier to HIV prevention, care and treatment efforts. This is because; the majorities of people with HIV who do not know they are infected, for a variety of reasons, came late for diagnosis and lately linked for care resulting in different negative outcomes. Objective: The objective of this study was to identify predictors for late HIV diagnosis among people living with HIV in Adare and Yirgalem general hospitals, SNNPR, Ethiopia. Method: Facility based unmatched case-control study design was used in the study and a total sample size of 438 (216 cases and 222 controls) were recruited from clients who were visiting the ART clinics of Adare hospitals and Yirgalem general Hospital from 10th February to 16th April, 2014. Cases were HIV positive individuals who have a CD4 cell count of <350/μl regardless of the clinical staging or WHO clinical stage III or IV regardless of their CD4 cell count at the time of diagnosis., while controls were HIV positive individuals who have CD4 cell count of >350/μl and WHO clinical stage I or II at the time diagnosis. Data was collected by trained ART clinic nurses of the respective hospitals through card review and face to face interview. Binary logistic regression and multiple logistic regression analysis were carried out to identify predictors of late HIV diagnosis. Data were presented using frequencies, percentages, odds ratio with 95% confidence interval. Results: Among the study participants 117 (54.2%) of cases and 71 (32.0%) of controls were males and with the mean and standard deviation of age 31.87+7.94 years among cases and 28.92+7.27 years among controls. Males, (Adjusted OR= 1.869, 95 % CI 1.159, 3.015) , older age (> 40 years), (Adjusted OR= 2.681, 95 % CI 1.203, 5.973), tested for illness/symptom, (Adjusted OR= 2.019, 95 % CI 1.091, 3.735) and opportunistic illness at diagnosis (Adjusted OR= 2.249, 95 % CI 1.448, 3.496) were independent predictors for late HIV diagnosis; whereas having lifetime sexual partner six and above (> 6) was associated with early presentation for diagnosis (Adjusted OR= 0.213, 95 % CI 0.068, 0.668). Conclusion and recommendation: Males, old age, testing due to symptom and opportunistic infection at diagnosis were independent predictors of late HIV diagnosis, whereas having lifetime sexual partner six and above have protective effect. The HIV prevention and control efforts and HIV testing programs should target males as well as older age groups and promoting routine HIV testing as part of regular medical care may contribute to the reduction of late HIV diagnosis. Further large scale study should be done including patients not attending ART clinic and clients visiting health facility with unknown HIV status.

Item Type:	Thesis (Masters)
Subjects:	Q Science > Q Science (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Africana
Depositing User:	Vincent Mpoza
Date Deposited:	27 Jun 2018 11:47
Last Modified:	27 Jun 2018 11:47
URI:	http://thesisbank.jhia.ac.ke/id/eprint/6036

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