Abstract:
Background: Eearly diagnosis and timely linkage to HIV medical care is necessary to monitor
clinical status of HIV disease progression and to derive maximal benefit from antiretroviral
therapy and other interventions. However, significant number 34.4% of People living with HIV
were present late to HIV/AIDS care in Ethiopia. Late presentation to HIV care that is
determined by many factors is a persisting problem in most developing countries, including
Ethiopia. Moreover, there was no empirical data on risk factors for late presentation to
HIV/AIDS care in the local context. Therefore this study aimed to asses risk factors associated
with late presentation to HIV/AIDS care among People living with HIV in Bench Maji Zone.
Methods: A case-control study design triangulated with qualitative approach was conducted in
one general hospital and eight health centers of Bench Maji Zone from March 01 to May
15/2014. For the qualitative data, a sample of 87 case and 174 controls were included in the
study using a consecutive sampling technique. Purposively 15 individuals were included in the
in-depth interview. Quantitative data were collected using pre- tested interview administered
questionnaire and analyzed using Statistical Package for Social Science Version 20.
Descriptive, Bivariate and multivariable logistic regression analysis was done to assess
association among variables. Qualitative data were analyzed using thematic analysis and
triangulated with quantitative finding.
Result: A total of 256 individuals were participated in the study, making a response rate of
98.1%. The independent predictors of late presentation to HIV/AIDS care were: being could
not read and write [AOR = 2.59, 95%CI: (1.21, 5.53)], perceived HIV as stigmatizing disease
[AOR = 2.50, 95% CI: (1.31, 4.76)], did not disclose their HIV status [AOR = 2.56,
95%CI:(1.37, 4.79)], alcohol consuming [AOR = 6.16,95%CI:(3.22, 11.78)] and traditional
care experienced for HIV status [AOR = 3.07, 95%CI:(1.54, 6.09)]. The qualitative findings
also explored that being not educate, perceive HIV stigma, alcohol users, non HIV status
disclosure, having HIV traditional care experience were the major barriers for early
presentation to HIV/AIDS care.
Conclusions and recommendations: Late presentation to HIV/AIDS care explained by not
read and write, HIV stigmatization, not disclose their HIV status, consuming alcohol and
having HIV traditional care experience. Thus, emphasise should given to address the identified
risk factors of late presentation to HIV/AIDS care.
