School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
PLoS One. 2024 Sep 13;19(9):e0310373. doi: 10.1371/journal.pone.0310373. eCollection 2024.
Globally, HIV infection remains a leading cause of morbidity and mortality. Despite reducing new infections, the global response to advanced HIV disease (AHD) remains ineffective, leaving HIV epidemics a significant public health threat worldwide. In Ethiopia, evidence regarding AHD is scarce. Therefore, this study aimed to assess the prevalence and predictors of AHD among newly diagnosed people living with HIV (PLHIV) initiating antiretroviral therapy in the Gedeo zone, southern Ethiopia.
A facility-based cross-sectional study was conducted from May 29, 2023, to February 06, 2024, at health facilities providing HIV care in the Gedeo zone, southern Ethiopia. A total of 427 PLHIV-initiating antiretroviral therapy (ART) were recruited for the study. The data were collected through face-to-face interviews and record reviews using KoboCollect version 2.4 and analyzed using R version 4.3.3. The Akaike information criterion (AIC) model selection was used to evaluate and choose the best-fitting model to describe the relationship between AHD and predictors. Finally, variables with a p-value less than 0.05 were considered independent predictors in the multivariable regression analysis.
The study participants' mean (±SD) age was 31.3 (±8.7) years. The overall prevalence of AHD among newly diagnosed PLHIV-initiating ART was 34.4% (95% CI: 29.8%, 39.1%). Rural residence (AOR = 3.48, 95% CI: 2.24, 5.47), alcohol consumption (AOR = 2.48, 95% CI: 1.59, 3.90), and being identified through community-based index case testing (ICT) (AOR = 0.26, 95% CI: 0.13, 0.51) were found to be independent predictors of AHD.
The prevalence of AHD among newly diagnosed individuals initiating ART was high. PLHIV who consume alcohol should receive detailed counseling on how it can negatively impact their progress with antiretroviral treatment. HIV testing should be enhanced in rural communities by strengthening community health campaigns. Furthermore, community-based index case testing should be strengthened for early identification of PLHIV.
在全球范围内，HIV 感染仍然是导致发病率和死亡率的主要原因。尽管新感染人数有所减少，但全球对晚期 HIV 疾病（AHD）的应对仍然无效，使 HIV 流行在全球范围内仍然是一个重大的公共卫生威胁。在埃塞俄比亚，关于 AHD 的证据很少。因此，本研究旨在评估在埃塞俄比亚南部 Gedeo 地区新诊断为 HIV 感染者（PLHIV）开始接受抗逆转录病毒治疗（ART）时 AHD 的流行率和预测因素。
这是一项基于机构的横断面研究，于 2023 年 5 月 29 日至 2024 年 2 月 6 日在 Gedeo 地区提供 HIV 护理的卫生设施中进行。共招募了 427 名开始接受抗逆转录病毒治疗（ART）的 PLHIV。数据通过面对面访谈和使用 KoboCollect 版本 2.4 进行记录回顾收集，并使用 R 版本 4.3.3 进行分析。采用 Akaike 信息准则（AIC）模型选择来评估和选择最适合描述 AHD 与预测因素之间关系的模型。最后，将 p 值小于 0.05 的变量视为多变量回归分析中的独立预测因素。
研究参与者的平均（±SD）年龄为 31.3（±8.7）岁。新诊断为 PLHIV 开始接受 ART 的患者中，AHD 的总体患病率为 34.4%（95%CI：29.8%，39.1%）。农村居民（AOR=3.48，95%CI：2.24，5.47）、饮酒（AOR=2.48，95%CI：1.59，3.90）和通过社区为基础的索引病例检测（ICT）确定（AOR=0.26，95%CI：0.13，0.51）被发现是 AHD 的独立预测因素。
新诊断为开始接受 ART 的个体中 AHD 的患病率很高。应向饮酒的 PLHIV 提供详细的咨询，告知他们饮酒会对其抗逆转录病毒治疗的进展产生负面影响。应通过加强社区卫生运动来加强农村社区的 HIV 检测。此外，应加强社区为基础的索引病例检测，以便早期发现 PLHIV。
