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. 2023 Sep 8;12(3):22799036231197194.
doi: 10.1177/22799036231197194. eCollection 2023 Jul.

Incidence and predictors of attrition among adults receiving first line anti-retroviral therapy at public health facility in Adea Berga district, Oromia, Ethiopia

Seifu Kassa  1 , Tariku Dingeta  2 , Tesfaye Gobana  2 , Tadesse Dufera  2
Affiliations

Incidence and predictors of attrition among adults receiving first line anti-retroviral therapy at public health facility in Adea Berga district, Oromia, Ethiopia

Seifu Kassa et al. J Public Health Res. .

Abstract

Background: According to current estimates, there are 665,723 people in Ethiopia who have human immunodeficiency syndrome. As Ethiopia inches closer to attaining the 95/95/95 targets for treatment coverage and reaching epidemic control, however, attrition from anti-retroviral treatment is still one of the key programmatic challenges.

Objective: To assess the incidence of attrition rate and its predictors among adult HIV patients receiving anti retro viral treatment at Public Health Facility in Adea Berga/Enchini District.

Method: A 6-year (June 28, 2015 to June 27, 2021) institution-based retrospective cohort study was used to recruit 540 study participants by using simple random sampling. Data were obtained from chart review, coded, entered into Epi Data, and exported to Stata 14.2 software for analysis. At least 1 month missed appointment is considered as attrition and the predictors of attrition were identified using bivariable and multivariable Cox proportional hazard models and an adjusted hazard ratio (AHR). Bivariate and multivariate analyses were conducted to find predictors of attrition, p-value < 0.05 was considered statistically significant.

Results: From the total 540 study participant, 158 (29.26%) patients were discontinuing from follow up making the incidence rate of attrition 9.50 per 100 person years .Being WHO clinical stage III or IV (AHR = 1.96,), non-practice of Appointment spacing model (AHR = 3.98), poor or fair ART adherence level (AHR = 6.47), age groups (15-24) years (AHR = 1.73) and Others ART linkage points[index case testing, tuberculosis clinic and referral from private/public health institutions] (AHR = 1.76) were significantly associated.

Conclusions: The study showed that the incidence of attrition among adults receiving antiretroviral therapy was high. Patient sociodemographic, clinical, and treatment-related factors were significantly associated with patients on ART.

Keywords: Anti-retro viral treatment; Ethiopia; HIV/AIDS; adult; attrition; incidence.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Profiles of HIV/AIDS clients in Adea Berga district Public Health Facilities (June 28, 2015 to June 27, 2021) Central Ethiopia; 2022. HC: health center; EHC: enchini health center; EPH: enchini primary hospital; TO: transferout.
Figure 2.
Figure 2.
Diagrammatic presentation of type outcome status among Adults Receiving ART Related with Attrition in Adea Berga district Public Health Facilities, central Ethiopia 2021, (n = 540). ART: anti-retro viral therapy.
Figure 3.
Figure 3.
Kaplan–Meier failure estimates by failure function of attrition among adult patients on ART in Adea Berga district Public Health Facilities, central Ethiopia 2022.
Figure 4.
Figure 4.
Kaplan–Meier survival estimates by survival function of attrition among adult patients on ART in Adea Berga district Public Health Facilities, central Ethiopia 2022.
Figure 5.
Figure 5.
Kaplan–Meier failure estimates by Adherence level of attrition among adult patients on ART in Adea Berga district Public Health Facilities, central Ethiopia 2022.
Figure 6.
Figure 6.
Kaplan–Meier failure estimates by baseline WHO stage of attrition among adult patients on ART in Adea Berga district Public Health Facilities, central Ethiopia 2022.
See this image and copyright information in PMC

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