Abstract:
Background: Loss to follow-up (LTFU) of HIV positive patients from antiretroviral
therapy (ART) reduces treatment benefits and leads to treatment failures. Determinants
of LTFU in ART patients were investigated in Oromia region, but various studies had
insufficient sample sizes and may not be generalizable to the entire population of the
region. The objectives of this study was to investigate the determinants of LTFU and
variations in health facilities among HIV patients receiving ART in Oromia Region.
Methods: A retrospective cohort study based on facility records was utilized and the
data were extracted from the dataset gathered collaboratively by Jimma University
Health Institute and Health Bureau of Oromia. Data cleaning and descriptive analysis
was done using SPSS while R software was used for inferencial analysis. Generalized
Estimating Equations was used to identify determinants of LTFU and variations
between health facilities was handled by considering confounding by cluster (CBC).
Result and Conclusion: A total of 875 patients from 19 facilities were included, of
whom 432 (49.40%) were lost. The predictors identified were being male (AOR =
1.669; 95% CI: 1.110, 2.510), female sex workers (AOR = 6.931; 95% CI: 1.560,
30.800), not being enroled in ASM (AOR = 3.925; 95% CI: 2.720, 5.670) and drug
regimen change/switch (AOR = 4.027; 95% CI: 2.700, 6.010). Low income level,
WHOclinical stage I and Within-cluster effect of poor adherence also have statistically
significant association with LTFU. The result also indicate that there is confounding
by cluster among the Health facilities. Therefore, health professionals working in
ART centers and potential stakeholders in HIV/AIDS care and treatment should
consider patients with these characteristics to prevent or minimize the rate of LTFU
of patients on ART.
