Determinants of Late Diagnosis of HIV Infection in the Era of Highly Active Antiretroviral Therapy in North-Eastern Ethiopia

Background: Delay in HIV diagnosis has been identified as the main determinant of late presentation to care and has a major impact on subsequent morbidity and mortality.

Objective: to determine late diagnosis of HIV infection and its correlates in northern Ethiopian.

 Methods: A Unmatched case-control study was carried out from March 10, 2010 to March 31, 2010 among 320 adult PLWHA (≥15 years) attending ART clinic at public hospitals of South Wollo zone in North-eastern Ethiopia. We used multivariable logistic regression model to predict independent risk factors of different covariates on late diagnosis of HIV.

Results: Regarding awareness of HIV testing, 63.8 % of cases and 56.9% of controls had been aware of existence of VCT and that it was for free before the first positive HIV testing. Not aware of existence of VCT (OR=3.66, 95% CI= 1.32, 10.19), having sickness/symptoms during HIV (OR= 0.561, 95% CI=0.357, 0.883), HIV testing with medical consultation (OR=0.464, 95% CI= 0.280, 0.770), HIV diagnosis sites (private clinic)OR=0.447, 95%CI=0.203, 0.986), HIV non-disclosure for spouse/sexual partner (OR=0.302, 95% CI=0.17, 0.536), HIV non-disclosure for families (OR=2.121, 95% CI=1.121, 3.713), negative HIV status of spouse/sexual partner (OR= 2.163, 95%CI = 1.062, 4.406) were the predictor of late diagnosis. The main reason mentioned for seeking HIV testing in cases was having symptoms/sickness (46.9%), whereas 35% of the controls sought testing because of medical consultations.

Conclusion: HIV infection was primarily found in those clients who have negative sero status of partner and non-disclosure to the family members were late diagnoses.  So encouraging sero status disclosure to the family members and early medical attendance/consultations for patients who have any illness is recommended for presentation and early enrollment of clients in to HIV care.