Factors Affecting Late Presentation for HIV/AIDS Care in Southwest Ethiopia: A Case Control Study

Abstract

Late presentation for HIV/AIDS care may occur either as a result of late testing for HIV or delayed presentation to HIV care after getting tested. Identificat ion of different risk factors associated with late HIV/AIDS care is essential to target interventions aimed at favoring early entrance into HIV/AIDS care. Therefo re, the objective of this study was to assess factors associated with late presentation for HIV/AIDS care in Jimma town, Southwest Ethiopia. Institution based unmatched case-control study triangulated with qualitative method was conducted at Jimma University Specialized Hospital and Jimma Health Center. A samp le of 103 cases and 206 controls were selected using a consecutive sampling technique. Purposively, selected health workers working in an Anti Retroviral Therapy clinic and selected HIV positive indiv iduals who were attending an Anti Retroviral Therapy clinic for the first time were included in an in-depth interview. The primary statistical methodology used was logistic regression analysis and all analyses were performed using the Statistical Package for Social Sciences software fo r windows version 16. Qualitative data were analy zed using thematic analysis and triangulated with quantitative findings. The following were correlated with increased risk of delayed HIV/AIDS care: Those who were divorced or separated (AOR=3.7, CI: 1.3-10.4), could formally read and write (AOR=3.7, CI: 1.6-8.7), perceived HIV as curable (AOR= 2.7, CI: 1.3-5.4), got tested by voluntary counseling and testing (VCT) (AOR=2.5, CI: 1.2-5.4), had symptoms of HIV at time of d iagnosis (AOR= 4.9, CI: 2.3-10.9), had chronic health problems (AOR= 2.7, CI: 1.2-5.9), had contact with a commercial sex worker (AOR= 3.00, CI: 1.4-6.5) and alcohol users (AOR= 3.8, CI: 1.8-7.9) as compared with their counterparts. The qualitative findings also showed that HIV stigma, non disclosure, low awareness, substance use, having contact with commercial sex workers, and poor lin kage after HIV testing were the major barriers for late presentation for HIV/AIDS care. In this study being separated or divorced, being educated, having signs and symptoms of HIV at diagnosis, having chronic health problems and having behavioral problems upon HIV d iagnosis were risk factors for late HIV/AIDS care. So, efforts to reduce late initiat ion of HIV/AIDS care should focus on addressing these risk factors.