Survival of adult people living with HIV in Rwanda

Abstract

This study aimed at investigating factors associated with survival of adult people living with HIV (PLHIV) in Rwanda. The assessment was made using demographic, socio-economic, clinical and immunological factors using secondary data source from Institute of HIV/AIDS, Disease Prevention and Control of RBC comprising of 2,084 PLHIV who enrolled into HIV care and treatment services from 1st January, 2004 to 31st December, 2004. The analysis was made using a time-to-event approach based on the Kaplan-Meier estimate, the Log-rank Chi-square test and Cox-Proportional Hazard Model. In the results, the median survival time of PLHIV was ranging between 5 and 6 years. Out of 2086 records, 908 PLHIV (43.6%) were dead. In the bivariate analysis, marital status, residence, and ART Regimens were not significant (p > 0.05). In the multivariate analysis, survival of adult PLHIV varied significantly by age , sex, education level, occupation, CD4 Count, and WHO Stage of disease were statistically significant (p < 0.05 ), implying difference in survival experiences of PLHIV according to those variables. Particularly, the risk of dying was lower among females PLHIV; PLHIV with secondary or higher education, PLHIV with CD4 Count greater than 350 mm3 . On the other hand, the risk of dying was higher among PLHIV aged 45 and above, PLHIV employed in informal sector or not working, and among PLHIV in WHO stage IV. In light of these findings, two measures for increasing the survival of PLHIV are recommended: improving socio-economic conditions of PLHIV and early initiation of PLHIV on ART.