The Prevalence of Advanced HIV Disease Among Adults Initiated on ART in the Western Oromia Region of Ethiopia

According to the World Health Organization, the rising number of individuals with HIV experiencing Advanced HIV Disease (AHD) poses a significant challenge to preventing new infections, complications, and HIV-related mortality despite the implementation of the test-and-treat approach. Ethiopia lacks empirical data on AHD, highlighting the need for further investigation. Therefore, this study aimed to assess the prevalence of AHD among adults initiating Anti reteroviral therapy (ART) to inform policy decisions and clinical practice.

A retrospective cross-sectional study was conducted in three high-volume public health hospitals using a systematic sampling technique. The Raosoft sample calculator was used to select a total sample of 544 patient records that met the inclusion criteria. A document review was conducted to examine the medical records of patients spanning from January 2017 to December 2021 by trained data collectors using a structured checklist.

Study findings indicated an increasing AHD prevalence of 41.7% with 95% CI (37.5 - 46.0) over five years, especially prominent in the 35-44 age group (38.7%) and among males (51.5%). Controversially, a higher mortality rate was observed in non-AHD patients compared to those with AHD, warranting further investigation.

The high prevalence of AHD, particularly among men and middle-aged adults on ART in public hospitals, requires policymakers to develop targeted aged and gender interventions, community awareness, and education at both facility and community levels about the importance of early HIV diagnosis and treatment and adherence to reduce complications and preventable deaths related to AHD, including building the capacity of HCPs to comply with guidelines in healthcare practice.