Abstract:
Background: Improved access to antiretroviral therapy is linked to higher survival and a decrease in
mortality. Since rapid expansion of ART program in Ethiopia, the number of AIDS death has shown
dramatically decline from 117.7/100,000 in 2001, to 11.73/100,000 in 2019. However, survival
status among people with HIV who started ART is variable, predictors vary for this mortality
variation according to the existing studies, and there are discrepancies in the results of those studies.
Moreover, as far as the author is aware, there was no study conducted in this study area on this topic.
Objective: To determine time to death and predictors of mortality among People living with HIV on
ART treatment at health facilities in Woliso district, Southwest Shoa Zone, Ethiopia.
Methods: Facility based retrospective cohort study was conducted from April 01 to 30, 2023 on
PLWHIV who were enrolled on ART from January 01, 2018 to December 30, 2022. To select study
participants, simple random sampling technique was used. Nurses through structured abstraction tool
using ODK collected data. STATA version 13 was used for data analysis. Kaplan–Meier was used
to estimate survival time, and log rank tests were used to compare survival curves. Bivariable and
multivariable cox proportional hazard regression analysis was used to determine the predictors of
survival time. The Cox-Snell residual plot was used to check the goodness of fit and Cox PH
assumption was checked by log log rank test and through graphical assessment. Results were
presented in statements, graphs and tables.
Result: 720 HIV infected patients on ART were participated in this study. The incidence rate of
mortality was 5.1 per 100 person years (95%CI: 4.01–6.50) during the follow-up period. The median
time to death was 21 months. Marital status: being divorced (AHR: 6.34 95% CI: 2.05, 19.65), WHO
clinical stage III and IV, (AHR: 2.92 95% CI: 3.12, 8.27), ART adherence: fair (AHR: 5.48 95% CI:
2.37, 12.66), and poor (AHR: 3.50 95% CI: 1.72, 7.09) were found to be predictors of mortality.
Conclusions: This study found high incidence of mortality among People on ART treatment in
comparison to previous studies. Marital status, WHO clinical stage and ART adherence were,
identified predictors of mortality. Therefore, enrolment of patients at WHO clinical stage I and II on
HIV care service and treatment and good drug adherence is very crucial to improve patients’
survival.
