Determining factors of late HIV diagnosis in Northern Ethiopia

Yassin Mohammed, Ephrem Mamo Gebrehiwot and Alemayehu Mekonnen

Background: Late diagnosis results in delayed treatment, higher medical costs and an increased risk of mortality. However many HIV-infected patients in Africa are often diagnosed at very advanced stages of the disease. This study aims to identify factors involved with late HIV diagnosis. Method: facility based cross-sectional survey was conducted at public health facilities which provide HIV care in Northern Ethiopia from January to May 2011. Four hundred thirty-seven HIV diagnosed patients who were on ART care and had a CD4 cell count within three months of their first HIV diagnosis were taken as study subjects. The impact of the variables on the likelihood of late testing was analyzed using binary logistic regression. P-values less than 0.05 and 95% confidence intervals were used to determine an association between independent and dependent variables. Results: Sixty two percent of the study subjects were defined as late testers. Males were twice as likely to test late as compared to females [2.12(1.25- 3.59)]. Having more than six sexual partners in life time was significantly associated with lower risks to testing late [0.22(0.05- 0.88)]. Testing for health related reasons showed a significant positive association (p<0.001). Those who had health problems prior to their HIV diagnosis came late for HIV testing [2.27(1.52-3.38)]. Fever persists for one month and unexplained weight loss were positively associated with late HIV diagnosis. Drug users were positively associated with late testing. Testing with medical consultation was associated with higher risks of late diagnosis. Testing during pregnancy follow up lowers the risk of late testing. Conclusion: HIV infected population groups at a higher risk of late HIV testing. The risk factors identified to be associated with late testing should be utilized in formulating targeted public health interventions in order to improve early HIV diagnosis.

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