Abstract:
Background: - Human immuno-deficiency virus (HIV) continuum of care demands early
antiretroviral therapy initiation including same day for all HIV-infected individuals. Early
antiretroviral therapy initiation reduces onward HIV transmission facilitating rapid viral
suppression. Despite this, not initiating antiretroviral therapy the same day of HIV diagnosis is a
challenge among newly diagnosed human immune-deficiency virus positive individuals.
Objective: - To identify determinants of non-same day antiretroviral therapy initiation among
Adult Patients attending ART clinic in Woliso Town health facilities, Oromia, Ethiopia, 2022
Methods: - Facility-based unmatched case-control study design was conducted in Woliso Town
Health Facilities, from August 26, 2022 to October 25, 2022. A total of 381 study participants
(127 cases and 254 controls) were included in the study. Simple random sampling technique was
used to select study participants for both cases and controls. The data were collected through
interviewer administered questionnaire and reviewing secondary data from antiretroviral therapy
registration books, patient follow up charts and intake forms to collect information like base line
CD4 count, functional status and WHO clinical stage. Data analysis was done using binary
logistic regression model. Ninety five percent (95%) confidence intervals (CI) with adjusted odds
ratios computed to identify the presence and strength of association. Statistical significance
declared at p-value < 0.05 along with 95% CI of the adjusted odds ratio (AOR).
Results: A total of 381 patients diagnosed with HIV were included in the study. Place of
residence (AOR=2.43, 95%CI: 1.52, 4.04), presence of opportunistic infection (AOR=2.44,
95%_CI: 1.30, 4.59), where HIV diagnosis made (AOR=4.03, 95%CI: 2.11, 7.70), knew ART
users (AOR=2.77, 95%CI: 1.38, 7.01) and ever use of alcohol_(AOR=2.19, 95%CI: 1.30, 3.71)
were factors that were significantly associated with non-same day ART initiation.
Conclusion: Presence of opportunistic infection, where HIV diagnosis made, knew ART users
before, place of residence and use of alcohol before ART initiation were determinants of non same day antiretroviral therapy initiation among patients aged above 15 years in Woliso Town.
