Analysis of Prevalence and Contributing Factors for Advanced HIV Disease at Wangaya Denpasar General Hospital: January 2022 to December 2023

Anak Agung Ayu Mita Astari; Ketut Suryana

doi:10.71341/bmwj.v1i1.8

Authors

Anak Agung Ayu Mita Astari Department of Internal Medicine, Wangaya HIV Study Group, Merpati Clinic, Wangaya General Hospital in Denpasar, Bali, Indonesia
Ketut Suryana Department of Internal Medicine, Wangaya HIV Study Group, Merpati Clinic, Wangaya General Hospital in Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.71341/bmwj.v1i1.8

Keywords:

Advanced HIV disease, psychosocial factors, epidemiology, HIV testing, mortality

Abstract

Background: Advanced HIV disease (AHD) remains a significant health concern and a leading cause of mortality among individuals living with HIV/AIDS. Understanding the psychosocial factors influencing AHD, such as social support, access to healthcare resources, and mental health conditions like depression, is vital for effective intervention.

Aim: This study aimed to determine the prevalence of AHD and identify the factors associated with it at Wangaya Denpasar General Hospital from January 2022 to December 2023.

Methods: A cross-sectional study was conducted involving all newly diagnosed AHD patients at the Merpati clinic, Wangaya General Hospital, during the specified period. Participants were selected based on inclusion and exclusion criteria, and data were collected through a comprehensive review of patients' medical records.

Results: Out of 128 newly diagnosed individuals living with HIV/AIDS (PLWHA), 84 (65.6%) were classified as having AHD. The majority of PLWHA with AHD were male (73.8%), under 50 years of age (82.1%), without a college education (94.0%), unemployed (83.3%), married (54.8%), had medical insurance (90.5%), contracted HIV through heterosexual contact (90.5%), were referred from other medical facilities (82.1%), and reported having social support (98.8%). Significant factors associated with AHD included lack of college education (p=0.000), unemployment (p=0.000), marital status (p=0.037), and referral source (p=0.010).

Conclusion: The findings indicate that lack of college education, unemployment, marital status, and being referred from other medical facilities are significant factors associated with AHD. To mitigate AHD-related morbidity and mortality, it is essential to enhance education and training programs focused on HIV/AIDS and to promote provider-initiated HIV testing and counseling. This approach could facilitate earlier prevention and diagnosis of HIV.

References

Ainembabazi, B., Katana, E., Bongomin, F., Wanduru, P., Mayega, R. W., & Mukose, A. D. (2024). Prevalence of advanced HIV disease and associated factors among antiretroviral therapy naïve adults enrolling in care at public health facilities in Kampala, Uganda. Therapeutic Advances in Infectious Disease, 11, 1–15. https://doi.org/10.1177/20499361241251936

Belaunzarán-Zamudio, P. F., Caro-Vega, Y. N., Shepherd, B. E., Rebeiro, P. F., Crabtree-Ramírez, B. E., Cortes, C. P., Grinsztejn, B., Gotuzzo, E., Mejia, F., Padgett, D., Pape, J. W., Rouzier, V., Veloso, V., Cardoso, S. W., McGowan, C. C., & Sierra-Madero, J. G. (2020). The population impact of late presentation with advanced HIV disease and delayed antiretroviral therapy in adults receiving HIV care in Latin America. American Journal of Epidemiology, 189(6), 564–572. https://doi.org/10.1093/aje/kwz252

Dat, V. Q., Lyss, S., Dung, N. T. H., Hung, L. M., Pals, S. L., Anh, H. T. Van, Kinh, N. Van, & Bateganya, M. (2021). Prevalence of Advanced HIV Disease, Cryptococcal Antigenemia, and Suboptimal Clinical Outcomes Among Those Enrolled in Care in Vietnam. Journal of Acquired Immune Deficiency Syndromes, 88(5), 487–496. https://doi.org/10.1097/QAI.0000000000002786

Hartley, J. (2021). Oxford Handbook of Tropical Medicine. In Bmj (Vol. 320, Issue 7236). https://doi.org/10.1136/bmj.320.7236.721/a

Hu, X., Liang, B., Zhou, C., Jiang, J., Huang, J., Ning, C., Liu, J., Zhou, B., Zang, N., Lai, J., Chen, R., Liao, Y., Pan, P., Liu, X., Lan, G., Pang, X., Ye, L., Shen, Z., & Liang, H. (2019). HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: A large-scale cross-sectional study. AIDS Research and Therapy, 16(1), 1–10. https://doi.org/10.1186/s12981-019-0221-7

Jiang, H., Liu, J., Tan, Z., Fu, X., Xie, Y., Lin, K., Yan, Y., Li, Y., & Yang, Y. (2020). Prevalence of and factors associated with advanced HIV disease among newly diagnosed people living with HIV in Guangdong Province, China. Journal of the International AIDS Society, 23(11), 1–11. https://doi.org/10.1002/jia2.25642

Kemenkes R1. (2019). Keptusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/90/2019 Tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana HIV,1-154

Kemenkes RI. (2022). Distribusi ODHIV yang di Tes per Provinsi dapat dilihat pada Grafik. Kementrian Kesehatan Republik Indonesia, 1–23.

Lebelonyane, R., Mills, L. A., Mogorosi, C., Ussery, F., Marukutira, T., Theu, J., Kapanda, M., Matambo, S., Block, L., Raizes, E., Makhema, J., Lockman, S., Bachanas, P., Moore, J., & Jarvis, J. N. (2020). Advanced HIV disease in the Botswana combination prevention project: Prevalence, risk factors, and outcomes. Aids, 34(15), 2223–2230. https://doi.org/10.1097/QAD.0000000000002627

Li, S. S., Li, K., Chen, H. H., Zhu, Q. Y., He, J. S., Feng, Y., Lan, G. H., & Shao, Y. M. (2024). Evaluation of factors associated with high advanced HIV disease and mortality in Southwestern China: a retrospective cohort study, 2005–2020. Public Health, 227, 282–290. https://doi.org/10.1016/j.puhe.2023.11.025

Lifson, A. R., Workneh, S., Hailemichael, A., MacLehose, R. F., Horvath, K. J., Hilk, R., Sites, A. R., & Shenie, T. (2019). Advanced HIV Disease among Males and Females Initiating HIV Care in Rural Ethiopia. Journal of the International Association of Providers of AIDS Care, 18, 1–7. https://doi.org/10.1177/2325958219847199

Mbewe, N., Vinikoor, M. J., Fwoloshi, S., Mwitumwa, M., Lakhi, S., Sivile, S., Yavatkar, M., Lindsay, B., Stafford, K., Hachaambwa, L., Mulenga, L., & Claassen, C. W. (2022). Advanced HIV disease management practices within inpatient medicine units at a referral hospital in Zambia: a retrospective chart review. AIDS Research and Therapy, 19(1), 1–6. https://doi.org/10.1186/s12981-022-00433-8

Mesic, A., Homan, T., Lenglet, A., Thit, P., Mar, H. T., Sabai, S. M., Thandar, M. P., Thwe, T. T., Kyaw, A. A., Decroo, T., Spina, A., Ariti, C., Ritmeijer, K., Van Olmen, J., Oo, H. N., & Lynen, L. (2023). Advanced HIV disease and associated attrition after re-engagement in HIV care in Myanmar from 2003 to 2019: a retrospective cohort study. International Health, 15(4), 453–461. https://doi.org/10.1093/inthealth/ihac069

Oboho, I. K., Esber, A. L., Dear, N., Paulin, H. N., Iroezindu, M., Bahemana, E., Kibuuka, H., Owuoth, J., Maswai, J., Shah, N., Crowell, T. A., Ake, J. A., & Polyak, C. S. (2024). Advanced HIV disease in East Africa and Nigeria, in The African Cohort Study. Journal of Acquired Immune Deficiency Syndromes, 96(1), 51–60. https://doi.org/10.1097/QAI.0000000000003392

Provinsi Bali, D. K. (2020). Profil Dinas Kesehatan Provinsi Bali 2020. Kesehatan Provinsi Bali 2020, 3, 103–111.

Stöger, L., Katende, A., Mapesi, H., Kalinjuma, A. V., van Essen, L., Klimkait, T., Battegay, M., Weisser, M., & Letang, E. (2022). Persistent High Burden and Mortality Associated With Advanced HIV Disease in Rural Tanzania Despite Uptake of World Health Organization “Test and Treat” Guidelines. Open Forum Infectious Diseases, 9(12), 1–9. https://doi.org/10.1093/ofid/ofac611

UNAIDS. (2018). HIV and Universal Health Coverage: A Guide for Civil Society. https://www.unaids.org/sites/default/files/media_asset/hiv-uhc-guide-civil-society_en.pdf

UNAIDS. (2023). Global HIV & AIDS statistics — Fact sheet. Fact Sheet 2023, 1–6. http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf

WHO. (2023). Providing Care To People With Advanced Hiv Disease Who Are Seriously Ill Policy Brief.