Acceptance of the Index Case HIV Testing and Associated Factors among Anti-Retroviral Therapy Patients in Public Health Facilities in Gedeo Zone, Southern Ethiopia. Cross-Sectional Study Design with Document Review

Abstract

Index case Human Immunodeficiency Virus (HIV) testing is a voluntary procedure wherein service providers request index clients to enumerate all sexual partners, including biological children, before proceeding with Human Immunodeficiency Virus (HIV) testing. This approach has demonstrated efficacy as a case-finding strategy aimed at curbing future transmission. Through index testing, we can pinpoint partners and children with undiagnosed infections, thereby facilitating early identification of Human Immunodeficiency Virus (HIV) -positive children who are currently healthy. The study aimed to assess the acceptance of index-case Human Immunodeficiency Virus (HIV) testing and its associated factors among anti-retroviral therapy (ART) patients in public health facilities within the Gedeo zone, southern Ethiopia. The study employed a cross-sectional design with a document review. It involved 396 anti-retroviral therapy (ART) patients and utilized a pretested checklist to extract data from clients’ medical records. A simple random sampling technique was used to select anti-retroviral therapy (ART) facilities in the Gedeo zone. Data collection was done from anti-retroviral therapy (ART) patient documents by ODK-Kobo Collect form and data analysis was conducted using statistical package for social science (SPSS) version 25, with bivariate and multivariate analyses performed to identify associations between index case testing and associated factors. A significance level of P ≤ .05 was adopted. The findings were presented in textual format, tables, and graphs, providing a comprehensive overview of the results. The magnitude of the acceptance of the index case testing among anti-retroviral therapy (ART) patients was 240 (60.6% [95% CI: 56%-65%]). Concerning the adherence status of the index case, 156 (39.4%) and 54 (13.6%) had good and poor adherence, respectively. Duration on ART (AOR = 2.30 [95% CI: 1.86, 6.12]), HIV disclosure (AOR = 36.19 [95% CI: 7.26, 180.44]), and good ART adherence status (AOR = 14.52 [95% CI: 2.10, 100.2]) are found to be factors significantly associated with acceptance of index case testing. The study findings indicated that the overall acceptance rate of index case testing was 60%, which falls short of the national benchmark minimum acceptance rate of 95%. Factors significantly linked to the acceptance of index case testing included the duration of ART usage, disclosure of HIV status, and adherence to ART medication. To improve the magnitude of the index case testing, the government and other NGOs working in these areas should work on health education, awareness creation, and improvement of treatment adherence. Ensure the sustainability of ICT services in ART facilities and the provision of quality HIV index case testing services.