Determinants Associated With CD4 Cell Count and Disclosure Status Among First-Line Antiretroviral Therapy Patients...

Background: In the last two decades, Human immune deficiency virus has been a major health concern in sub-Saharan Africa particularly in Ethiopia. The objective of this study was to identify determinants associated with CD4 cell count and disclosure status among first-line antiretroviral therapy patients treated at Felege Hiwot Comprehensive Specialized Hospital, Ethiopia. Methods: This retrospective study was conducted at Felege Hiwot Comprehensive Specialized Hospital. Data analysis was conducted using Statistical System Analysis (SAS) software Version 9.4. In this study, quasi-Poisson mixed-effects model for CD4 cell count, a binary logistic regression model for disclosure status, and joint modeling were used. Result: Out of 300 adult participants, around 76% of the patients were discloses their disease status to their family members. The correlation between CD4 cell count and disclosure was positive (0.4607). The current study indicates that among the predictor variables, noneducators (β = -0.6185, p-value < 0.01), primary educators (β = -0.3687, p-value < 0.01), employed patients (β = 0.3888, p-value < 0.01), adherent patients (β = 0.2274, p-value < 0.01), and patients who did not had social support (β = -0.1148, p-value = 0.030) have a significant effect for CD4 cell count. Similarly, noneducators (AOR = 0.000145, p-value < 0.01), primary educators (AOR = 0.004413, p-value < 0.01), employed patients (AOR = 3.4562, p-value = 0.021), adherent patients (AOR = 1.564, p-value < 0.01), and patients who did not had social support (AOR = 0.075, p-value = 0.0078) had a significant effect for disclosure status. Conclusion: This study concluded that patients who had disclosed their disease status to near relatives or families have a positive correlation with CD4 cell count through time. This study also concluded that significant determinants affected both the variables of interest were educational level, occupation, adherence, and social support. Health professionals should give more attention to these important determinants to create good status of patients. In addition, health staff should conduct health-related studies for individuals to understand better ART follow-up. Patients should be adhere to their prescribed HIV medication properly on time and disclose their disease status without fearing stigma and discrimination to the community; this may help to increase their CD4 cell count. The family members should give social support to the infected patients, and the government should work on education; this may help to improve their CD4 cell count and increase the prevalence of disclosure of the disease status. The authors also recommended that further studies of this nature include other important variables that are not included in this study such as income of the patients and many other covariates.