HEALTH OUTCOME AMONG ADULT ANTIRETROVIRAL THERAPY SERVICE USERS UNDER HUMAN IMMUNODEFICIENCY VIRUS TEST AND TREAT PROGRAM IN WEST HARARGHAE ZONE PUBLIC HEALTH FACILITIES ASTERN ETHIOPIA

Abstract

Background: Globally 38 million people were living with human immunodeficiency virus and among them 1.7 million were newly infected and thousands had died of the disease. Ethiopia is one of HIV high burden countries with a prevalence of 1.1%. Globally universal test and treat strategy launched in 2016, Ethiopia had adopted the test and treat recommendation since February 2017. and since then, all HIV-positive clients are eligible to start antiretroviral therapy right away. In Ethiopia, evidences on the health outcome of test and treat antiretroviral therapy users and pre- dictors are limited. Objectives: To assess health outcomes of human immunodeficiency virus test and treat program among adult service users in west hararghae public health facilities eastern Ethiopia from April, 20-May 20/2023 Method: A retrospective cohort study was conducted among 517 adult anti-retroviral therapy ser- vice users in West Hararghe Public health facility. Data were extracted by using pre-tested check- list guided by the anti-retroviral therapy registration logbook and patient intake card. Then, sample was selected by using multi stage sampling technique. Collected data were entered in to Epi-Data version 3.1 and exported to STATA version 15 for analysis. Data were analyzed using descriptive statistics and Cox regression model was used to identify predictors and the result was presented using the Adjusted Hazard ratio at 95% confidence interval. Results: The result of this study showed that the proportion low CD4 and viral load greater than 200 copies were 28.82%(95%CI:25.07,32.89) and 13.15%(95%CI:10.50,16.36) respectively. Among those CD4 count less than 500 cells /mm3 the median time to CD4 count less than 500 cells /mm3 was 19.5months(95%CI:18.03,20.76), whereas among those who develop viral load greater than 200 copies the median time to develop high viral load was 18 months(95%CI:14.5,22.7). The incidence to develop low CD4 count was 43.4(95%CI:36.4,50.4) per 1000 person-months of observation, whereas the incidence to develop high viral load was 48.8(95%CI:37.2,60.5) per 1000 person-months of observation. Female ART service users were 90% (AHR=1.90,95%CI:1.27-2.82, WHO Assessment of Moderate pain 181%(AHR=2.81,95%CI:1.19-6.63), viral load greater than 200 copies 330% (AHR= 4.30,95%CI:2.79- 6.63) were associated with increased risk of CD4 count less than 500 cells /mm3 as compared with their counterpart. In contrast Normal body mass index 63%(AHR=0.37,95%CI:0.15-0.91) were associated with reduced risk of CD4 count less than 500 cells /mm3 as compared with their counterpart. Being rural resident was 92%(AHR=1.92,95%CI:1.05-3.52), Opportunistic infection 238% (AHR=3.38,95%CI:1.61-7.15, WHO Clinical Second Stage were 87%(AHR=0.13,95%CI:0.02-0.66), CD4 count less than 500 cells /mm3 were 426%(AHR=5.26,95%CI:3.06-9.03) were associated with increased risk of viral load greater than 200 cop- ies as compared with their counterpart. Conclusion: The health outcome among adult ART service users under HIV test and treat program were low CD4 count and High viral load. Targeted evaluation for the factors identified and consid- ering them during care and follow up is important to prevent adverse health outcome from ART service management