Factors associated with late presentation to hiv/aids Care in bench maji zone: case control study, southwest Ethiopia

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.