Survival Time and Associated Factors Among Adults Living with HIV After Initiation of HAART in South Gondar, Northwest Ethiopia: A Retrospective Cohort.

Background Antiretroviral therapy consistently improves the survival of people living with HIV and contributes to preventing the development of new infections. Studies of antiretroviral therapy programs in Africa have shown a high mortality rate during the first 6 months after initiation of HAART in rural health facilities. This study looks at survival time and associated factors among adults with HIV in south Gondar, Northwest Ethiopia. Methods A 5-year retrospective cohort study design was conducted using patient records among 746 adults living with HIV/AIDS. A systematic random sampling technique was used to select respondents after proportional allocation was made for all health facilities included in the study. Epi-info version 7 and STATA 12 were used for data entry and analysis, respectively. Kaplan-Meier survival analysis was used to estimate mean survival time and a life table was used to estimate survival probability after initiation of HAART. Results A total of 746 respondents were followed for a median of 60 months. There were 102 (13.67%) deaths yielding an overall mortality rate of 2.59/1,000-person year observation (95% CI=0.02136-0.031736). Age of respondents >43 years (AHR=2.790; 95% CI=1.495-5.206), bedridden (AHR=9.57; 95% CI=3.87-23.64), past TB treatment (AHR=0.86; 95% CI=0.46-0.609), baseline WHO stage IV (AHR=3.02; 95% CI=1.77-5.18), pneumonia after ART start (AHR=3.6; 95% CI=1.4-9.2), INH prophylaxis (AHR=2.58; 95% CI=1.232-5.188), ambulatory functional status (AHR=5.86; 95% CI=2.67-12.86), and disclosure status (AHR=0.423; 95% CI=0.261-0.685) were significant predictors for survival time after initiation of HAART among adults living with HIV. Conclusion The mortality rate was highly (13.67%) observed in the early phase of antiretroviral treatment. Being ambulatory and bedridden, age of respondents >43 years, past TB treatment, baseline WHO stage IV, pneumonia after HAART, INH prophylaxis, and disclosure status were independent predictors of mortality.