Prevalence of Advanced HIV Disease and Associated Factors Among Antiretroviral Therapy Naïve Adults Enrolling in Care at Public Health Facilities in Kampala, Uganda

Overview

Journal Ther Adv Infect Dis

Publisher Sage Publications

Specialty Infectious Diseases

Date 2024 May 21

PMID 38770168

Authors

Bridget Ainembabazi

Elizabeth Katana

Felix Bongomin

Phillip Wanduru

Roy William Mayega

Aggrey David Mukose

Affiliations

Soon will be listed here.

Abstract

Background: Despite adoption of the 'test-and-treat' strategy, a high proportion of antiretroviral therapy (ART) naïve people living with HIV (PLHIV) enrol in care with, and die of advanced HIV disease (AHD) in Uganda. In this study, we aimed to determine the prevalence of AHD among ART naïve adults enrolling in care and associated factors at selected public health facilities in Kampala, Uganda.

Methods: From April to July 2022, we conducted a mixed-methods study at Kiswa Health Centre III, Kitebi Health Centre III, and Kawaala Health Centre IV. The study involved cross-sectional enrolment and evaluation of 581 participants, utilizing an interviewer-administered questionnaire and chart reviews. Modified Poisson regression was employed to identify factors associated with AHD, complemented by a qualitative component comprising fifteen in-depth interviews, with data analysed through thematic analysis.

Results: Overall, 35.1% (204/581) of the study participants had AHD. Being male [adjusted prevalence ratio (aPR): 1.4, 95% CI: 1.04-1.88] and aged 35-50 years (aPR: 1.81, 95% CI: 1.14-2.88) were associated with AHD. Participants with no personal health perception barriers had 37% lower odds of presenting to care with AHD (aPR: 0.63, 95% CI: 0.46-0.85). Qualitative findings indicated that individual factors, such as waiting until physical health deteriorated and initially opting for alternative therapies, took precedence in contributing to enrolment in care with AHD.

Conclusion: Over one in every three ART naïve adults presents to public health facilities in Uganda with AHD. Male gender, age 35-50 years, and personal health perception barriers emerged as significant factors associated with AHD; emphasizing the need for targeted interventions to address these disparities and enhance early detection and engagement in care. Routine HIV testing should be emphasized and incentivized especially for men and persons aged 35-50 years.

Citing Articles

A cross-sectional study evaluating the screening, diagnosis and management of advanced HIV disease at the AIDS support organization service centre in Mbarara City, Southwestern Uganda.

Tukamuhebwa P, Gemmell I BMC Infect Dis. 2025; 25(1):254.

PMID: 39988695 PMC: 11849361. DOI: 10.1186/s12879-025-10682-3.

Advanced HIV disease and its predictors among newly diagnosed PLHIV in the Gedeo zone, southern Ethiopia.

Lerango T, Markos T, Yehualeshet D, Kefyalew E, Lerango S PLoS One. 2024; 19(9):e0310373.

PMID: 39269935 PMC: 11398689. DOI: 10.1371/journal.pone.0310373.

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