ArticleJournal of the International AIDS Society2016
Factors associated with initiation of antiretroviral therapy in the advanced stages of HIV infection in six Ethiopian HIV clinics, 2012 to 2013.
Article in Journal of the International AIDS Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Treatment failure among Sub-Sahara African children living with HIV: a systematic review and meta-analysis.Italian journal of pediatrics · 2024Pooled it
- Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review.AIDS research and therapy · 2023Pooled it
- HIV/AIDS treatment failure and associated factors in Ethiopia: meta-analysis.BMC public health · 2020Pooled it
- Factors affecting linkage to HIV care and ART initiation following referral for ART by a mobile health clinic in South Africa: evidence from a multimethod study.Journal of behavioral medicine · 2019Trial
- Prevalence, trend and risk factors for antiretroviral therapy discontinuation among HIV-infected adults in Ethiopia in 2003-2015.PloS one · 2017Trial
- Time to initiation of antiretroviral therapy and its predictors among newly diagnosed HIV positive at the selected public health centers in Adama Town, Ethiopia.AIDS research and therapy · 2025Article
- Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis.Belitung nursing journal · 2025Review
- Barriers and enabling structural forces affecting access to antiretroviral therapy in Nigeria.BMC public health · 2024Article
- Factors associated with late initiation of antiretroviral therapy in Iran's HIV/AIDS surveillance data.Scientific reports · 2024Article
- Pill Burden: A Major Barrier to HAART Adherence and Fixed Dose Combinations (FDCS) as its Solution - A Mini-Review.Current HIV research · 2024Review
- Predictors of delayed Anti-Retroviral Therapy initiation among adults referred for HIV treatment in Uganda: a cross-sectional study.BMC health services research · 2023Article
- Perspectives of people living with HIV on barriers to timely ART initiation following referral for antiretroviral therapy: A qualitative study at an urban HIV clinic in Kampala, Uganda.PLOS global public health · 2023Article
- Article
- Experiences of Antiretroviral Therapy Initiation Among HIV-Positive Adults in Ethiopia: A Descriptive Phenomenological Design.HIV/AIDS (Auckland, N.Z.) · 2022Article
- Article
- Improvement in depressive symptoms after antiretroviral therapy initiation in people with HIV in Rakai, Uganda.Journal of neurovirology · 2021Observational
- Time to Antiretroviral Therapy Initiation and Its Predictors Among Newly Diagnosed HIV-Positive People in Nekemte Town, Western Ethiopia: Claim of Universal Test and Treat.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Article
- Psychological Distress and Its Correlates among Newly Diagnosed People Living with HIV in Northwest Ethiopia: Ordinal Logistic Regression Analyses.Infectious diseases · 2021Article
- ART use and associated factors among HIV positive caregivers of orphans and vulnerable children in Tanzania.BMC public health · 2020Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
introductionMost HIV-positive persons in sub-Saharan Africa initiate antiretroviral therapy (ART) with advanced infection (late ART initiation). Intervening on the drivers of late ART initiation is a critical step towards achieving the full potential of HIV treatment scale-up. This study aimed to identify modifiable factors associated with late ART initiation in Ethiopia.
methodsFrom 2012 to 2013, Ethiopian adults (n=1180) were interviewed within two weeks of ART initiation. Interview data were merged with HIV care histories to assess correlates of late ART initiation (CD4+ count <150 cells/µL or World Health Organization Stage IV).
resultsThe median CD4 count at enrollment in HIV care was 263 cells/µL (interquartile range (IQR): 140 to 390) and 212 cells/µL (IQR: 119 to 288) at ART initiation. Overall, 31.2% of participants initiated ART late, of whom 85.1% already had advanced HIV disease at enrollment. Factors associated with higher odds of late ART initiation included male sex (vs. non-pregnant females; adjusted odds ratio (aOR): 2.02; 95% CI: 1.50 to 2.73), high levels of psychological distress (vs. low/none, aOR: 1.96; 95% CI: 1.34 to 2.87), perceived communication barriers with providers (aOR: 2.42, 95% CI: 1.24 to 4.75), diagnosis via provider initiated testing (vs. voluntary counselling and testing, aOR: 1.47, 95% CI: 1.07 to 2.04), tuberculosis (TB) treatment prior to ART initiation (aOR: 2.16, 95% CI: 1.43 to 3.25) and a gap in care of six months or more prior to ART initiation (aOR: 2.02, 95% CI: 1.10 to 3.72). Testing because of partner illness/death (aOR: 0.64, 95% CI: 0.42 to 0.95) was associated with lower odds of late ART initiation.
conclusionsProgrammatic initiatives promoting earlier diagnosis, engagement in pre-ART care, and integration of TB and HIV treatments may facilitate earlier ART initiation. Men and those experiencing psychological distress may also benefit from targeted support prior to ART initiation.
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