Determinants of Non-Same Day Antiretroviral Therapy Initiation among Adult Patients Attending Antiretroviral Clinic In Woliso Town Health Facilities, Oromia, Ethiopia, 2022: Case Control

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.