Same-day antiretroviral treatment (ART) initiation and associated factors among HIV positive people in Northwest Ethiopia: baseline characteristics of prospective cohort

Nurilign Abebe Moges; Olubukola Adeponle Adesina; Micheal A Okunlola; Yemane Berhane

doi:10.1186/s13690-020-00473-4

Same-day antiretroviral treatment (ART) initiation and associated factors among HIV positive people in Northwest Ethiopia: baseline characteristics of prospective cohort

Arch Public Health. 2020 Sep 22:78:87. doi: 10.1186/s13690-020-00473-4. eCollection 2020.

Authors

Nurilign Abebe Moges^{1

2}, Olubukola Adeponle Adesina^{3

4}, Micheal A Okunlola^{3

4}, Yemane Berhane⁵

Affiliations

¹ Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
² Pan African University, Life and Earth Sciences Including Health and Agriculture Institute (PAULESI), University of Ibadan, Ibadan, Nigeria.
³ Department of Obstetrics and Gynecology, College of medicine, University of Ibadan, Ibadan, Nigeria.
⁴ Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria.
⁵ Department of Epidemiology, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

Abstract

Background: Despite a well-established fact that same-day or rapid ART initiation after a positive HIV test result is vital for faster viral suppression and for prevention of further sexual transmissions of HIV, there is a paucity of evidence on the uptake of same-day ART initiation among newly HIV diagnosed people in Northwest, Ethiopia.

Methods: A cross-sectional study was conducted between December 1st, 2018 and July 30, 2019. About 759 newly HIV diagnosed adults were recruited from 24 health facilities. Data were collected using interviewer-administered questionnaire. Data were entered using EPI-Data and exported to SPSS and STATA software for further analysis. Bivariate logistic regression was used to select candidate variables at p-value less than 0.25 for multivariate logistic regression. Then adjusted odds ratio with 95% Confidence Interval (CI) at p-value of less than 0.05 was used to declare the statistical associations between the dependent and independent variables.

Result: Magnitude of same-day ART initiation was 318 (41.90%) [(95% CI, 38.2-45.20%)]. Factors associated with same-day ART initiation were: Patients resided in West Gojjam Zone were 2.04 times more likely to initiate same-day ART compared to those in Bahir Dar city administration [AOR = 2.04 (1.04-3.97)], patients in the health centers were 3.06 times more likely to initiate same-day ART initiation compared to those in the hospitals [AOR = 3.06 (1.90-4.92)] and Patients who were diagnosed their HIV status at the same health facility where they linked for ART were 2.16 times more likely to initiate ART at the same-day of diagnosis [AOR = 2.16 (91.24-3.74)]. Moreover, patients with no opportunistic infection [AOR = 2.08 (1.04-4.19)] and pregnant women [AOR = 3.97 (1.78-8.87)] were more likely to initiate ART same-day of diagnosis.

Conclusions: Same-day ART initiation was low among HIV patients in Ethiopia. Patients attending their treatment at hospitals and those from big city (Bahir Dar) were less likely to initiate same-day ART. Clinical factors such as having opportunistic infections and non-pregnancy status affected the immediate initiation of treatment. HIV positive people who seek care in hospitals and those tested HIV positive from another health facilities in which they did not intend to continue their ART follow-up care need special attention.

Keywords: ART; Ethiopia; New HIV patients; Same-day treatment initiation.