Frailty status and associated factors among older PLHIV in Southern Ethiopia

Studies addressing frailty are limited in the global south, including Ethiopia. We estimated the prevalence of frailty and associated factors among older people living with HIV (PLHIV) attending a large Comprehensive Specialized Hospital in southern Ethiopia.

A systematic sample of 187 PLHIV and 187 HIV-negative controls > 50 years old were recruited between October 1 and November 30, 2021. Data on socio-demographic, behavioural and clinical characteristics were collected using a structured questionnaire. Frailty assessments were completed using the brief frailty instrument (B-FIT-2), which consists of 6 components. Scoring 5-6 points was frail, 2-4 points were pre-frail and below 2 was considered as non-frail. Logistic regression model was used to measure association between variables.

Median (IQR) age was 53 (50, 80) for PLWH and 59 (55-66) for controls. Prevalence of frailty was 9.1% for PLHIV Versus 5.9% for controls. A significant proportion of PLHIV was pre-frail; 141 (75.4%) compared to controls 110 (58.8%). Pre-frailty status was associated with HIV diagnosis (adjusted odds ratio (aOR) 4.2; 95% CI 1.8-9.9), low age (aOR 0.3; 95% CI 0.1-0.6), lower educational attainment (aOR 2.2; 95% CI 1.0-4.9), being farmer (aOR 3.2; 95% CI 1.0-10.2) and having high or low body mass index (BMI) (aOR 11.3; 95% CI 4.0-25.8). HIV diagnosis (aOR 9.7; 95% CI 1.6-56.8), age (aOR 0.2; 95% CI 0.1-0.7), lower educational attainment (aOR 5.2; 95% CI 1.5-18.2), single status (aOR 4.2; 95% CI 1.3-13.6), farmer (aOR 19.5; 95% CI 3.5-109.1) and high or low BMI (aOR 47.3; 95% CI 13.8-161.9) predicted frailty.

A high proportion of frailty and pre-frailty was observed in a cohort of older PLHIV attending care in Southern Ethiopia. Future research should focus on interventions targeting factors associated with frailty.