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Factors associated with unawareness of HIV-positive status in urban Ethiopia : Evidence from the Ethiopia population-based HIV impact assessment 2017-2018

Lulseged, Sileshi ; Belete, Wudinesh ; Ahmed, Jelaludin ; Gelibo, Terefe ; Teklie, Habtamu ; West, Christine W ; Melaku, Zenebe ; Demissie, Minilik LU orcid ; Farhani, Mansoor and Eshetu, Frehywot , et al. (2021) In PLoS ONE 16(8). p.1-17
Abstract

BACKGROUND: The HIV epidemic in Ethiopia is concentrated in urban areas. Ethiopia conducted a Population-based HIV Impact Assessment (EPHIA) in urban areas between October 2017 and April 2018 to measure the status of the country's response to the epidemic.

METHODS: We conducted field data collection and HIV testing in randomly selected households using the national, rapid testing algorithm with laboratory confirmation of seropositive samples using a supplemental assay. In addition to self-report on HIV diagnosis and treatment, all HIV-positive participants were screened for a set of HIV antiretroviral (ARV) drugs indicative of the first- and second-line regimens. We calculated weighted frequencies and 95% confidence intervals to... (More)

BACKGROUND: The HIV epidemic in Ethiopia is concentrated in urban areas. Ethiopia conducted a Population-based HIV Impact Assessment (EPHIA) in urban areas between October 2017 and April 2018 to measure the status of the country's response to the epidemic.

METHODS: We conducted field data collection and HIV testing in randomly selected households using the national, rapid testing algorithm with laboratory confirmation of seropositive samples using a supplemental assay. In addition to self-report on HIV diagnosis and treatment, all HIV-positive participants were screened for a set of HIV antiretroviral (ARV) drugs indicative of the first- and second-line regimens. We calculated weighted frequencies and 95% confidence intervals to assess regional variation in participants' level of unawareness of their HIV-positive status (adjusted for ARV status).

RESULTS: We interviewed 20,170 survey participants 15-64 years of age, of which 19,136 (95%) were tested for HIV, 614 (3.2%) tested positive, and 119 (21%) of HIV-positive persons were unaware of their HIV status. Progress towards the UNAIDS first 90 target (90% of people living with HIV would be aware of their HIV status by 2020) substantially differed by administrative region of the country. In the bivariate analysis using log binomial regression, three regions (Oromia, Addis Ababa, and Harari), male gender, and young age (15-24 years) were significantly associated with awareness of HIV positive status. In multivariate analysis, the same variables were associated with awareness of HIV-positive status.

CONCLUSION: One-fifth of the HIV-positive urban population were unaware of their HIV-positive status. The number of unaware HIV-positive individuals has a different distribution than the HIV prevalence. National and regional planning and monitoring activities could address this potentially substantial source of undetected HIV infection by increasing HIV testing among young people, men and individuals who do not use condoms.

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type
Contribution to journal
publication status
published
keywords
Adolescent, Adult, Anti-Retroviral Agents/therapeutic use, Behavior, Cost of Illness, Ethiopia/epidemiology, Female, HIV Infections/drug therapy, HIV Testing, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Self Report, Socioeconomic Factors, Young Adult
in
PLoS ONE
volume
16
issue
8
article number
e0255163
pages
1 - 17
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:34380145
  • scopus:85112268490
ISSN
1932-6203
DOI
10.1371/journal.pone.0255163
language
English
LU publication?
no
id
5fb71ab8-6ccb-4613-99cc-56bbbc7420db
date added to LUP
2021-11-25 10:16:47
date last changed
2021-11-26 04:07:58
@article{5fb71ab8-6ccb-4613-99cc-56bbbc7420db,
  abstract     = {<p>BACKGROUND: The HIV epidemic in Ethiopia is concentrated in urban areas. Ethiopia conducted a Population-based HIV Impact Assessment (EPHIA) in urban areas between October 2017 and April 2018 to measure the status of the country's response to the epidemic.</p><p>METHODS: We conducted field data collection and HIV testing in randomly selected households using the national, rapid testing algorithm with laboratory confirmation of seropositive samples using a supplemental assay. In addition to self-report on HIV diagnosis and treatment, all HIV-positive participants were screened for a set of HIV antiretroviral (ARV) drugs indicative of the first- and second-line regimens. We calculated weighted frequencies and 95% confidence intervals to assess regional variation in participants' level of unawareness of their HIV-positive status (adjusted for ARV status).</p><p>RESULTS: We interviewed 20,170 survey participants 15-64 years of age, of which 19,136 (95%) were tested for HIV, 614 (3.2%) tested positive, and 119 (21%) of HIV-positive persons were unaware of their HIV status. Progress towards the UNAIDS first 90 target (90% of people living with HIV would be aware of their HIV status by 2020) substantially differed by administrative region of the country. In the bivariate analysis using log binomial regression, three regions (Oromia, Addis Ababa, and Harari), male gender, and young age (15-24 years) were significantly associated with awareness of HIV positive status. In multivariate analysis, the same variables were associated with awareness of HIV-positive status.</p><p>CONCLUSION: One-fifth of the HIV-positive urban population were unaware of their HIV-positive status. The number of unaware HIV-positive individuals has a different distribution than the HIV prevalence. National and regional planning and monitoring activities could address this potentially substantial source of undetected HIV infection by increasing HIV testing among young people, men and individuals who do not use condoms.</p>},
  author       = {Lulseged, Sileshi and Belete, Wudinesh and Ahmed, Jelaludin and Gelibo, Terefe and Teklie, Habtamu and West, Christine W and Melaku, Zenebe and Demissie, Minilik and Farhani, Mansoor and Eshetu, Frehywot and Birhanu, Sehin and Getaneh, Yimam and Patel, Hetal and Voetsch, Andrew C},
  issn         = {1932-6203},
  language     = {eng},
  number       = {8},
  pages        = {1--17},
  publisher    = {Public Library of Science (PLoS)},
  series       = {PLoS ONE},
  title        = {Factors associated with unawareness of HIV-positive status in urban Ethiopia : Evidence from the Ethiopia population-based HIV impact assessment 2017-2018},
  url          = {http://dx.doi.org/10.1371/journal.pone.0255163},
  doi          = {10.1371/journal.pone.0255163},
  volume       = {16},
  year         = {2021},
}