Advanced HIV Disease among Males and Females Initiating HIV Care in Rural Ethiopia

Alan Raymond Lifson, Sale Workneh, Abera Hailemichael, Richard Fleming MacLehose, Keith Joseph Horvath, Rose Hilk, Anne Redmond Sites, Tibebe Shenie

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1 Scopus citations

Abstract

Despite recommendations for rapidly initiating HIV treatment, many persons in sub-Saharan Africa present to care with advanced HIV disease. Baseline survey and clinical data were collected on 1799 adults newly enrolling at 32 district hospitals and local health HIV clinics in rural Ethiopia. Among those with complete HIV disease information, advanced HIV disease (defined as CD4 count <200 cells/mm3 or World Health Organization [WHO] HIV clinical stage III or IV disease) was present in 66% of males and 56% of females (P <.001). Males (compared to females) had lower CD4 counts (287 cells/mm3 versus 345 cells/mm3), lower body mass index (19.3 kg/m2 versus 20.2 kg/m2), and more WHO stage III or IV disease (46% versus 37%), (P <.001). Men reported more chronic diarrhea, fevers, cough, pain, fatigue, and weight loss (P <.05). Most initiating care in this resource-limited setting had advanced HIV disease. Men had poorer health status, supporting the importance of earlier diagnosis, linkage to care, and initiation of antiretroviral therapy.

Original languageEnglish (US)
JournalJournal of the International Association of Providers of AIDS Care
Volume18
DOIs
StatePublished - May 17 2019

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the National Institute of Mental Health, NIH (grant: 1R01MH105290-01A1).

Funding Information:
The authors thank Lindsey Fabian and Madelyn Tillemans from the University of Minnesota; Lucy Slater from the National Alliance of State and Territorial AIDS Directors Global Program; and the Southern Nations, Nationalities, and Peoples? Region Regional Health Bureau. The authors especially thank all people living with HIV for their generous participation in this study. Ethiopian study coordinators were Anteneh Mengistu, Behailu Dagne, Engidaw Ayele, Hiwot Tekle, Simret Girma, Signe Tefera, Tesfaye Gemechu, Tsedey Ayele, Tewabe Tamiru, and Yayush Tesfaye. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the National Institute of Mental Health, NIH (grant: 1R01MH105290-01A1).

Publisher Copyright:
© The Author(s) 2019.

Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.

Keywords

  • CD4 count
  • HIV
  • advanced HIV disease
  • gender
  • sub-Saharan Africa

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