Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa zone, Oromiya, Ethiopia, 2018.

BACKGROUND: A key goal of Antiretroviral Treatment (ART) is to achieve and maintain durable viral suppression. Thus, the most important use of viral load measurement is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East Shewa Zone, Oromiya, Ethiopia. METHODS: Patients diagnosed with Human Immunodeficiency Virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurements were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of (Statistical Package for the Social Sciences) SPSS, International Business Machines (IBM) Inc. Significance group comparison was done by Kaplan Meier log-rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. RESULT: Plasma viral load was suppressed below the detection level in 72% of individuals taking a different regimen of ART. The median Human Immunodeficiency virus (HIV)-1 plasma viral load in the cohort was estimated to be log 5.3111 copies/ml. The study observed Survival curve difference in the category of marital status (p-value 0.023) and baseline cluster of differentiation 4 (CD4) value (p-value 0.023). The estimated median time to Plasma Viral Load (PVL) suppression was 181 days (CI: 140.5-221.4) with the age group of 30-39 years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was found among the age group between 50 and 59 years. CONCLUSION: The study found that the estimated time to achieve PVL after taking ART to be 181 days. Factors affecting time to suppression level were marital status and baseline CD4.

Youth-friendly health service in Ethiopia: Assessment of care friendliness and user's satisfaction.

BACKGROUND: Health facilities' level of readiness to provide adolescent and youth-friendly health services (AYFHS) is crucial for preventing and reducing teenage pregnancies and maternal mortality. This study examined friendliness and satisfaction with AYFHS among users. METHODS: A cross-sectional study was conducted among 419 adolescents and youths recruited from six health institutions in the East Shewa Zone, Oromia region, and Addis Ababa, Ethiopia from August 1 to October 28, 2022. Based on the WHO Quality Assessment Guidebook, the friendliness of AYFHS was evaluated as a proxy for the quality of care. Descriptive measures were computed to summarize the participants' socio-demographic characteristics. Bivariate and multivariable logistic regression analysis was used to evaluate the potential association between each independent variable and client satisfaction. The type, magnitude, and precision of association were presented using an adjusted odds ratio (AOR) with 95% Confidence Intervals (CI) and a p-value of < 0.05 ascertained statistical significance. RESULTS: The overall friendliness was 69%: Specifically, 82% of the participants stated the service was accessible, 72% said it was acceptable, and 90% thought it was effective. However, only 33% and 34% of respondents reported the services were equitable and appropriate respectively. The overall satisfaction with AYFHS was 25.3%. Increased age (AOR = 0.70, 95% CI: 0.57-0.86), being female (AOR = 0.11, 95%CI: 0.04-0.33), no prior information about AYFHS (AOR = 0.20, 95%CI: 0.10-0.44), and higher number of sexual partners (AOR = 0.3, 95%CI: 0.21-0.65) were factors statistically associated with client satisfaction with AYFHS. CONCLUSIONS: The overall quality of AYFHS was sub-optimal and did not meet the four components of WHO's good quality standards; equity, appropriateness, acceptability, and accessibility must be improved. Female and older adolescents and youths and those with a higher number of sexual partners should be targeted for intervention.