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Factors associated with late presentation to HIVAIDS care in South Wollo ZoneEthiopia a case-control study.doc

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Factors associated with late presentation to HIVAIDS care in South Wollo ZoneEthiopia a case-control study

Abaynewetal.AIDSResearchandTherapy2011,8:8 /content/8/1/8 RESEARCH OpenAccess Factorsassociatedwithlatepresentationto HIV/AIDScareinSouthWolloZoneEthiopia: acase-controlstudy YeshewasAbaynew1,AmareDeribew2,KebedeDeribe3* Abstract Background:AccesstofreeantiretroviraltherapyinSub-SaharanAfricahasbeensteadilyincreasing.Thesuccess oflarge-scaleantiretroviraltherapyprogramsdependsonearlyinitiationofHIV/AIDscare.Thepurposeofthe studywastoexaminefactorsassociatedwithlatepresentationtoHIV/AIDScare. Methods:Acase-controlstudywasconductedinDessiereferralandBorumedadistricthospitalsfromMarch1to 31,2010,northernEthiopia.Atotalof320studyparticipants(160casesand160controls)wereincludedinthe study.CaseswerepeoplelivingwithHIV/AIDS(PLHA)whohadaWHOclinicalstageofIIIorIVoraCD4 lymphocytecountoflessthan200/uLatthetimeofthefirstpresentationtoantiretroviraltreatment(ART)clinics. ControlswerePLHAwhohadWHOstageIorIIoraCD4lymphocytecountof200/uLormoreirrespectiveof clinicalstagingatthetimeoffirstpresentationtotheARTclinicsofthehospitalscasesandcontrolswere interviewedbytrainednursesusingapre-testedandstructuredquestionnaire.In-depthinterviewswereconducted withtenhealthworkersandeightPLHA. Results:PLHAwholivewiththeirfamilies[OR=3.29,95%CI:1.28-8.45)],livedinarentedhouse[OR=2.52,95%CI: 1.09-5.79],non-pregnantwomen[OR=9.3,95%CI:1.93-44.82],whoperceivedARThavemanysideeffects[OR= 6.23,95%CI:1.63,23.82)],whoperceivedHIVasstigmatizingdisease[OR=3.1,95%CI:1.09-8.76],whotestedwith sickness/symptoms[OR=2.62,95%CI:1.26-5.44],whodidnotdisclosetheirHIVstatusfortheirpartner[OR=2.78, 95%CI:1.02-7.56],frequentalcoholusers[OR=3.55,95%CI:1.63-7.71]andwhospentmorethan120monthswith partneratHIVdiagnosis[OR=5.86,95%CI:1.35-25.41]weresignificantlyassociatedwithlatepresentationtoHIV/ AIDScare.Thequalitativefindingrevealedlowawareness,non-disclosure,perceivedARTsideeffectsandHIV stigmawerethemajorbarriersforlatepresentationtoHIV/AIDScare. Conclusions:EffortstoincreaseearlyinitiationofHIV/AIDScareshouldfocuson