Sociodemographic and Clinical Determinants of Adults With Advanced HIV Disease on Antiretroviral Therapy in West Oromia, Ethiopia: A Hospital‐Based Retrospective Study

Background HIV/AIDS remains a significant public health challenge, with many individuals developing advanced HIV disease despite the scale‐up of antiretroviral therapy worldwide. Determinants related to sociodemographics, clinical practice and laboratory service associated with advanced HIV disease are not well known in sub‐Saharan Africa, such as Ethiopia. This study examines the potential sociodemographics and clinical practice of determinants of advanced HIV disease among adults on antiretroviral therapy in the West Oromia Region, Ethiopia. Methods A hospital‐based retrospective study was employed. The Raosoft online sample calculator was used to estimate a sample of 544 patient medical records in the study. A systematic sampling technique was used to select participants who met the inclusion criteria from three purposively selected public hospitals between January 2017 and December 2021. Descriptive statistics were applied to the dataset after it was cleaned and validated in EpiData, and the final analysis was performed in SPSS Version 29. Bivariate and multivariate logistic regression models were used to analyse sociodemographic and clinical practice factors associated with advanced HIV disease, with p < 0.05. Results The study revealed sociodemographic and clinical practice determinants associated with advanced HIV disease among adults, which includes male sex (adjusted odds ratio [AOR] = 1.85 and 95% confidence interval [CI] 1.18–2.90), the presence of HIV signs and symptoms (AOR = 2.83 [95% CI 1.74–4.61]) and OIs (AOR = 3.44 [95% CI 2.01–5.92]) at the time of antiretroviral therapy enrolment, bedridden and ambulatory health conditions (AOR = 3.58 [95% CI 1.76–7.31]), and low CD4 cell count of less than 200 cells/mm3 accounted for 127 (36.5%) at treatment initiation while having CD4 test results at baseline data collections participants (AOR = 1.97 [95% CI 1.20–3.23]), and 84 (37%) of those delayed ART initiation (AOR = 1.75 [95% CI 1.08–2.83]). 42 (7.7%) had ART on ≤ 1–7 days and 143 (26.3%) in > 7 days. These significantly correlated with the development of advanced HIV disease or OIs at a p value of < 0.05 among this study population. Only 359 (66%) had same‐day ART. Conclusion The findings highlight the importance of early HIV diagnosis and initiation of antiretroviral therapy, adherence to treatment regimens and monitoring for OIs in the prevention and management of advanced HIV disease. Therefore, the study calls for male‐targeted interventions, strengthening the capacity of healthcare providers, and a review of protocols for early HIV diagnosis and care to enhance patient health outcomes.