Abstract:
Human immunodeficiency virus (HIV) is a virus that attacks the immune
system. Globally, more than 79.3 million people have been infected with it and about 36.3
million people have died since the beginning of the epidemic. Ethiopia is one of the major
affected countries in sub-Saharan Africa, with a huge number of people that are living with
HIV. The identification of recent HIV-1 infection plays a crucial role in guiding prevention
and control interventions. However, the magnitude and associated factors of recent HIV-1
infections at health facilities in the Harari region are not adequately investigated.
Objective: This study aimed to assess the burden and identify factors associated with recent
HIV-1 infection among newly identified HIV positives tested with the Asante Rapid
Recency Assay from January 1, 2019, to December 30, 2023 at health facilities in the Harari
region, Eastern Ethiopia.
Methods: A cross-sectional study design was employed using HIV-1 diagnoses data from
January 1, 2019, to December 30, 2023 of case-based surveillance system in Harari region,
at health facilities in the Harari region. A total of 580 eligible study subjects were included
in the study. The data was collected using data extraction tool. Descriptive statistics such as
frequencies, percentages and means were used to summarize the characteristics of the study
participants and factors. Logistic regression was used to identify factors associated with
recent infection, adjusting for confounders. Results was presented as adjusted odds ratios
with 95% confidence intervals at p < 0.05.
Results: Among a total of 580 newly identified HIV positives tested for HIV recency in the
Harari region from 2019 to 2023. The magnitude of recent HIV infection was 53 (9.1%)
(95% CI: 7.0%, 11.8%). The highest proportion of recent HIV infection among the newly
identified HIV positives tested for recency test were in the year 2019 (9(22.5%)) and in 2020
(9(17%)). The study also found that primary educational level (AOR = 6.346, 95% CI =
2.07-19.391), no formal education (AOR = 4.755, 95% CI = 1.406-16.08), having sex in the
last 12 months (AOR = 5.508, 95% CI = 2.167-15.7), having sex with known/suspected HIV
positive (AOR = 4.35, 95% CI = 1.455-13.04) and Illicit drug use (AOR = 57.8, 95% CI =
16.19-207.5) had higher likelihood of being a recent HIV infection.
Conclusion: The study concluded that there is ongoing transmission of HIV within the
community. This transmission is driven by lower educational level, recent sexual activity,
sex with high-risk partners, and drug use. This study underscores the importance of
strengthening targeted HIV prevention interventions.
