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.
Highlights
human immunodeficiency virus (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
The future course of its epidemic in Ethiopia depends on a number of factors including HIV/ acquired immunodeficiency syndrome (AIDS)-related knowledge, social stigmatization, risk behavior modification, access to high-quality services for sexually transmitted infections (STIs), provision and uptake of HIV counseling and testing, and access to antiretroviral therapy (ART) [2]
Socio-demographic characteristics Out of the total of 392 people living with HIV (196 cases and 196 controls), 376 (96 % response rate) provided appropriate data
Summary
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. Delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. For over 20 years, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) have been significant public health problems in low- and middle- income countries, with two-thirds of the world’s HIV-infected population living in Africa [1]. It is one of the most serious public health and development challenges in Ethiopia [2]. The future course of its epidemic in Ethiopia depends on a number of factors including HIV/ AIDS-related knowledge, social stigmatization, risk behavior modification, access to high-quality services for sexually transmitted infections (STIs), provision and uptake of HIV counseling and testing, and access to antiretroviral therapy (ART) [2]
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