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Open Access 01-12-2019 | Tuberculosis | Research article

Sex difference in survival status among antiretroviral therapy users in Yirgalem general hospital, Sidama zone, south nations nationalities and peoples’ region (SNNPR), Ethiopia: retrospective cohort study

Authors: Mahilet Berhanu Habte, Gurmesa Tura Debelew, Tsedach Alemu Abebe

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Antiretroviral treatment (ART) has been shown to enhance the survival of people living with HIV worldwide. In Ethiopia, the number of ART users has increased from 47,422 in 2005 to 703,516 in 2017; yet, early mortality of patients has presented challenges to the success of the ART program. Because of gender roles, it is assumed that females are at risk of dying earlier after the start of the medications. Hence, this study aimed to assess the sex difference in the survival status among the ART users.

Methods

A retrospective cohort study was conducted in March 2017 among sample of 687 ART users registered from 2010 to 2015. Data were extracted from patient records by using a structured checklist. The extracted data were analyzed by STATA version 13. Survival analysis and Cox regression were used to determine survival status and identify associated factors.

Results

Among 685 reviewed records of ART users, 20 males and 64 females died in the 5 years period of ART initiation. This makes the overall 5 years survival rate of 84.23%. Females had lower survival probability (80.10%) as compared to males (91.18%) (Adjusted Hazard Ratio (AHR) = 1.79; 95% CI: 1.04, 3.06). Divorced individuals as compared to married (AHR = 2.09; 95% CI: 1.10, 3.97), individuals with less education (AHR = 2.54 95% CI: 1.29, 4.98) or those who attended only primary education (AHR = 2.07; 95% CI: 1.18, 3.65) as compared to those who attended secondary or above had low survival probability. Those who never disclosed their HIV status (AHR = 3.62; 95% CI: 1.25, 10.46) as compared to disclosed, bedridden individuals as compared to normal functional status (AHR = 2.7; 95% CI: 1.24, 5.89) and those who had tuberculosis (TB)-co infection (AHR = 2.60; 1.48, 4.45) had lower rates of survival.

Conclusion

Females were at higher risk of dying within 5 years of ART initiation as compared to males. Hence, intervention to further reduce mortality should take sex differences into account. Behavioral interventions and HIV counseling service should also be strengthened to improve rate of disclosure and functional status as well as reduce TB co-infections.

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Title: Sex difference in survival status among antiretroviral therapy users in Yirgalem general hospital, Sidama zone, south nations nationalities and peoples’ region (SNNPR), Ethiopia: retrospective cohort study
Authors: Mahilet Berhanu Habte
Gurmesa Tura Debelew
Tsedach Alemu Abebe
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Tuberculosis
Tuberculosis
Human Immunodeficiency Virus
Acquired Immune Deficiency Syndrome
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7672-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sex difference in survival status among antiretroviral therapy users in Yirgalem general hospital, Sidama zone, south nations nationalities and peoples’ region (SNNPR), Ethiopia: retrospective cohort study

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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