Factors associated with delay in starting anti-retroviral treatment among confirmed HIV positive individuals in state health facilities in Northern Namibia
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Date
2024
Authors
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Journal ISSN
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Publisher
University of Namibia
Abstract
The purpose of this study was to investigate the factors associated with the delay in
starting anti-retroviral treatment (ART) among confirmed HIV-positive individuals in
Northern Namibia, specifically the four (4) districts of the UTAP region (Andara,
Nyangana, Oshikuku and Tsumeb). The study employed the time series analytical
(quantitative) research design that used secondary data retrieved from the Electronic
Patient Management System (ePMS) database. The characteristics of data obtained
from the ePMS included the Who-stage, age, gender, facility type, CD4 count and
District. The study’s population was 1824, and the sample size was 1824, as total
population sampling was used in this desktop analysis. Descriptive statistics were used
to help explore more on objectives one and two of the study. The multivariate (LOGIT)
regression model was used to ascertain factors behind the delay in starting the ART
among confirmed HIV+ individuals. The study’s results indicated that most confirmed
HIV+ individuals opted for an early ART start, whereby the age, facility, gender,
CD4+ counts were statistically significant. The highest rate of confirmed HIV+
patients starting ART on the same day was in March 2018 (86.3%), followed by June
2018 (80.3%) and February 2018 (80.3%).
The study recommended that treatment literacy for service providers and health care
workers on the importance of starting treatment early, enhanced counselling, support
for men by male champions, easy of access to ART as essential to ensure confirmed
HIV+ people to access the ART in time from day of diagnosis up to day seven. Also,
the cost-effectiveness of ART related services, such as decentaralization and
equipping of facililities equitably as relevant in reducing the delay in starting ART
initiation
Description
A thesis submitted in partial fulfillment of the requirements for the degree of master of public health
Keywords
ART, HIV+, ePMS, Who-stage, Age, Gender, CD4, Viral load suppression, Namibia