MAGNITUDE AND ASSOCIATED FACTORS OF RECENT hiv-1 INFECTION AMONG NEWLY IDENTIFIED HIV-POSITIVE TESTED WITH THE ASANTE RAPID RECENCY ASSAY IN HEALTH FACILITIES OF HARARI REGION, EASTERN ETHIOPIA

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.