HIV/AIDS: Research and Palliative Care (Jan 2023)
Same-Day ART Initiation and Associated Factors Among People Living with HIV on Lifelong Therapy at Nekemte Specialized Hospital, Western Ethiopia
Abstract
Lami Bayisa,1 Diriba Bayisa,2 Ebisa Turi,3 Diriba Mulisa,1 Tadesse Tolossa,3 Adugna Olani Akuma,1 Merga Chala Bokora,2 Dawit Tesfaye Rundasa1 1Department of Nursing, School of Nursing and Midwifery, Wollega University, Nekemte, Ethiopia; 2Department of Midwifery, School of Nursing and Midwifery, Wollega University, Nekemte, Ethiopia; 3Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, EthiopiaCorrespondence: Lami Bayisa, Department of Nursing, School of Nursing and Midwifery, Wollega University, P.O.Box: 395, Nekemte, Ethiopia, Tel +251 924318135, Email [email protected]: The test-and-treat approach recommends early ART initiation (same day). Early ART start has double the benefits as treatment and as prevention. However, there is limited information regarding same-day ART initiation in Ethiopia. Hence, this study aimed to assess the magnitude and factors of same-day ART initiation among people living with HIV (PLHIV) on ART at Nekemte specialized hospital, in Western Ethiopia.Methods: A cross-sectional study was conducted among 483 PLHIV from January 10 to February 15, 2021. Data were collected using an investigator-administered questionnaire. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Variables with P-value < 0.25 from bivariable analysis were included in the multivariable analysis. AOR with 95% CI and P-value < 0.05 were used to declare statistical significance.Results: A total of 483 study subjects participated and gave a 100% response rate. Two thirds (65%) of them started ART on the same day with a 95% CI [60.2– 68.8]. Urban dwellers (AOR = 3.93 (95% 1.96– 7.87)), with no OIs (AOR = 4.02 (95% CI: 1.54– 10.47)), not screened for TB (AOR = 6.02 (95% CI: 1.71– 21.15)), tested via VCT (AOR = 2.32 (95% CI: 1.37– 3.26)), who have not used CPT (AOR = 1.88 (95% CI: 1.10– 3.23)), who have not used IPT (AOR = 2.36 (95% CI: 1.0– 5.57)), who were tested in 2019/20 (AOR = 2.37 (95% CI: 1.08– 5.518)), and with BMI ≥ 25 kg/m2 (AOR = 2.18 (95% CI: 1.05– 4.52)) were significantly associated with same-day ART initiation.Conclusion: Two thirds of study subjects initiated ART on the same day as HIV diagnosis. Voluntary testing and immediate referral to HIV care, advocating test-and-treat, and intensive counseling should be strengthened and reinforced for newly diagnosed HIV-positive people. Given that, high attention should be paid to individuals from urban residence, not screened for TB, who have not used CPT and IPT prophylaxis.Keywords: antiretroviral therapy, ART initiation, same day
