High prevalence of late presentation with advanced HIV disease and its predictors among newly diagnosed patients in Kumasi, Ghana
Date
2024
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Infectious Diseases
Abstract
Background Late presentation with advanced HIV disease (LP-AHD) remains a significant challenge to Human
Immunodeficiency Virus (HIV) care, contributing to increased morbidity, mortality, and healthcare costs. Despite
global efforts to enhance early diagnosis, a considerable proportion of individuals with HIV infection are unaware of
being infected and therefore present late for HIV care. For the first time in Ghana, this study assessed the prevalence of
LP-AHD and associated factors among people diagnosed with HIV (PDWH).
Method This bi-center retrospective cross-sectional study included 315 PDWH at the Aniniwah Medical Centre and
Komfo Anokye Teaching Hospital, both in Kumasi, Ghana. A well-structured questionnaire was used to collect data
on sociodemographic, clinical, lifestyle and psychosocial factors from the study participants. Statistical analyses were
done in SPSS version 26.0 and GraphPad Prism version 8.0 at significant p-value of <0.05 and 95% confidence interval.
Predictors of LP-AHD were assessed using binary logistic regression models.
Results This study observed that, 90 out of the 315 study PDWH (28.6%) reported late with advanced HIV disease
(AHD). Participants within the age group of 36–45 years (adjusted Odds Ratio [aOR]: 0.32, 95% CI: 0.14–0.69; p=0.004)
showed a significantly decreased likelihood of LP-AHD. However, participants who perceived cost of HIV care to
be high (aOR: 7.04, 95% CI: 1.31–37.91; p=0.023), who were diagnosed based on clinical suspicion (aOR: 13.86, 95
CI: 1.83–104.80; p=0.011), and missed opportunities for early diagnosis by clinicians (aOR: 2.47, 95% CI: 1.30–4.74;
p=0.006) were significantly associated with increased likelihood of LP-AHD. Conclusion The prevalence of LP-AHD among PDWH in Ghana is high. Efforts to improve early initiation of HIV/AIDS
care should focus on factors such as the high perceived costs of HIV care, diagnosis based on clinical suspicion, and
missed opportunities for early diagnosis by physicians.
Description
Research Article