Factors associated with delayed diagnosis of HIV infection in Mukono district, Uganda

Ddamulira, John Bosco; Rutebemberwa, Elizeus; Tumushabe, Elly; Nuwaha, Fred

doi:10.4314/eamj.v86i9.54162

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Furthermore, those who earn below the poverty datum line are likely to be self-employed hence do not have access to work related testing and counseling services, which are enjoyed by their formally employed counterparts. Also, those who earn less are likely to be more preoccupied with selling their wares that they may not be cognizant of the need to visit the health facility regularly [ 23 ]. In the study by Louis, it was also reported that harsh poverty was a theme of all of the respondents.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with late presentation for HIV/AIDS care in Harare City, Zimbabwe, 2015

et al. 2016

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BackgroundDespite widespread awareness and publicity concerning Human Immunodeficiency Virus (HIV) care and advances in treatment, many patients still present late in their HIV disease. Preliminary review of the Antiretroviral Therapy (ART) registers at Wilkins and Beatrice Road Hospitals, both located in Harare, indicated that 67 and 71 % of patients enrolled into HIV/AIDS care presented late with baseline CD4 of <200 cells/uL and/or WHO stage 3 and 4 respectively. We therefore sought to explore factors associated with late presentation in Harare City.MethodsWe conducted a 1:1 unmatched case control study where a case was an HIV positive individual (>18 years) with a baseline CD4 of <200/uL or who had WHO clinical stage 3 or 4 at first presentation to OI/ART centres in 2014 and; a control was HIV positive individual (>18 years) who had a baseline CD4 of >200/uL or WHO clinical stage 1 or 2 at first presentation in 2014. Written informed consent was obtained from all study participants.ResultsA total of 268 participants were recruited (134 cases and 134 controls). Independent risk factors for late presentation for HIV/AIDS care were illness being reason for test (Adjusted Odds Ratio [aOR] =7.68, 95 % CI = 4.08, 14.75); Being male (aOR = 2.84, 95 % CI = 1.50, 5.40) and; experienced HIV stigma (aOR = 2.99, 95 % CI = 1.54, 5.79). Independent protective factors were receiving information on HIV (aOR = 0.37, 95 % CI = 0.18, 0.78) and earning more than US$250 per month (aOR = 0.32, 95 % CI = 0.76, 0.67). Median duration between first reported HIV positive test result and enrolment into pre-ART care was 2 days (Q1 = 1 day; Q3 = 30 days) among cases and 30 days (Q1 = 3 days; Q3 = 75 days) among controls.ConclusionLate presentation for HIV/AIDS care in Harare City was a result of factors that relate to the patient’s sex, reason for getting a test, receiving HIV related information, experiencing stigma and monthly income. Based on this evidence we recommended targeted interventions to optimize early access to testing and enrolment into care.

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Section: Discussionmentioning

confidence: 99%

Factors associated with late presentation for HIV/AIDS care in Harare City, Zimbabwe, 2015

et al. 2016

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“…Language problems, ignorance, and unclear practices around the health assessment, HIV testing, and rules for permission to stay in Sweden led many immigrants to avoid HIV testing, but the Swedish authorities provided no new context to the immigrant population to counteract these fears and prejudices. In one recent quantitative study, factors associated with delayed diagnosis of HIV in a Ugandan population were investigated [ 24 ]. It was found that good access to healthcare, thorough information on HIV, and previous experiences related to HIV are important factors that affect how individuals relate to HIV testing.…”

Section: Discussionmentioning

confidence: 99%

Fogging the issue of HIV - Barriers for HIV testing in a migrated population from Ethiopia and Eritrea

2015

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BackgroundThe outcome of HIV treatment has dramatically improved since the introduction of antiretroviral therapy. Studies confirm that if treatment of HIV is initiated when the immune system is not severely affected by the virus the prognosis for the outcome is significantly better. There is also evidence that many immigrants come late for their first HIV test. If found to be HIV positive, and if the immune system is already significantly affected, this will compromise the treatment outcome. This study was performed in an attempt to understand the barriers for early HIV testing in a migrant population from Ethiopia and Eritrea in Stockholm, Sweden.MethodsParticipants were theoretically sampled and consisted of individuals who had immigrated from Ethiopia and Eritrea. Data were collected using 14 focus group discussions and seven semi-structured interviews. The analysis was performed according to a Grounded Theory approach using the paradigm model.ResultsDenial and fear of knowing one’s HIV status dominated all aspects of behavior in relation to HIV. The main strategy was a “fogging” of the issue of HIV. People were said to not want to know because this would bring social isolation and exclusion, and it was often believed that treatment did not help. This attitude had strong roots in their culture and past experiences that were brought along to the new country and maintained within the immigrant community. The length of time spent in Sweden seemed to be an important factor affecting the “fogging of the HIV issue”.ConclusionsIn bridging the gap between the two cultures, Swedish authorities need to find ways to meet the needs of both earlier and newly arrived immigrants as well as the second generation of immigrants. This will require adjusting and updating the information that is given to these different sub-groups of Ethiopian and Eritrean immigrants. Appropriate access to healthcare for a diverse population obviously requires more than simply providing the healthcare services.

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“…This was in agreement with a study in Venezuela [ 29 ] where low knowledge of HIV/AIDS and lack of awareness of the free HIV program was among factors associated with HIV testing. Similarly, in Uganda [ 35 ], lack of knowledge of testing services was shown to be significantly associated with delay in HIV testing. There is lack of published study done in Ethiopia assessing knowledge as a factor for late diagnosis and hence this limits us to compare our current finding in Ethiopian situation.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Late HIV Diagnosis among Adult People Living with HIV/AIDS Who Undertake an Initial CD4 T Cell Evaluation, Northern Ethiopia: A Case-Control Study

Beyene

2015

PLoS ONE

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IntroductionEarly HIV testing and timely initiation of ART is critical for the improved quality of life of PLWHIV. Having identified a higher rates of Late HIV diagnosis, this study was aimed to determine Determinants of late diagnosis of HIV among adult HIV patients in Bahir Dar, Northern Ethiopia.MethodsA case control study was conducted between January 2010 to December 2011 at Bahir Dar Felege Hiwot Referral Hospital. The study subjects consisted of 267 cases and 267 controls. Cases were adult people living with HIV/AIDS whose initial CD4 T cell count was < 200/μl of blood. Controls were those with a CD4 T cell count of greater than 200/ μl. Trained staff nurses were involved in data collection using a semi-structured questionnaire. Data was entered and analyzed using SPSS version 20. Descriptive statistics and Binary logistic regression were performed.ResultsSubjects who hold a certificate and above (AOR = 0.26; 95% CI = 0.13. 0.54), being initiated by friends, families and other socials to undertake HIV testing (AOR = 0.65; 95% CI = 0.29, 1.48), who reported a medium and high knowledge score about HIV/AIDS and who undertake HIV testing while visiting a clinic for ANC (AOR = 0.40; 95% CI = 0.19, 0.83) were less likely to be diagnosed late. Subjects who undertake HIV testing due to providers’ initiation (AOR = 1.70; 95%CI = 1.08, 2.68), who reported a medium internalized stigma (AOR = 4.94; 95% CI = 3.13, 7.80) and who reported a high internalized stigma score towards HIV/AIDS (AOR = 16.64; 95% CI = 8.29, 33.4) had a high odds of being diagnosed late compared to their counterparts.ConclusionInternalized stigma, low knowledge level about HIV/AIDS, not to have attended formal education and failure to undertake HIV testing by own initiation were significant determinant factors associated with Late HIV diagnosis. Education about HIV/AIDS, promotion of general education, and encouraging people to motivate their social mates to undertake HIV testing are highly recommended.

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Factors associated with delayed diagnosis of HIV infection in Mukono district, Uganda

Cited by 3 publications

References 17 publications

Factors associated with late presentation for HIV/AIDS care in Harare City, Zimbabwe, 2015

Factors associated with late presentation for HIV/AIDS care in Harare City, Zimbabwe, 2015

Fogging the issue of HIV - Barriers for HIV testing in a migrated population from Ethiopia and Eritrea

Predictors of Late HIV Diagnosis among Adult People Living with HIV/AIDS Who Undertake an Initial CD4 T Cell Evaluation, Northern Ethiopia: A Case-Control Study

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