The Magnitude and Associated Factors of Early Index Case Testing Among Adult HIV Index Cases at Debre Markos Town High Load Health Facilities 2023

Abstract

Introduction: Early human immunodeficiency virus (HIV) testing of partners or families of the index case is an innovative type of testing which is performed within 14 days after contact elicitation using a contractual referral approach. Testing within this time is very important because it helps to identify contacts early and enroll them for intervention timely. In most health facilities, the contractual approach was not practiced; by implementing this early index case testing, most contacts could be tested early and it could prevent them from HIV-related death. Objective: This study aimed to assess the magnitude and associated factors of early index case testing among adult HIV index cases in Debre Markos town high case load health facilities. Methods: Institution-based cross-sectional study was conducted on adult index cases who started antiretroviral therapy from December 1/2018 to August 30/2022. A total of 384 index case charts were selected by the systematic random sampling technique using their medical record number from January 23/2023 up to February 28/2023. After the data were collected using a structured checklist, they were entered into EpiData Version 4.6 and then exported to SPSS software Version 25 for data cleaning, coding, categorizing, and further analysis. The Hosmer–Lemeshow test goodness of fit was checked for model fitness. Both bivariable and multivariable logistic regression analyses were used to identify significant factors with early testing of index cases’ families. Finally, variables having pvalue < 0.05 with 95% CI in the multivariable logistic regression are considered as significant factors. Result: In this study, the magnitude of early index case testing among adult index patients was 28.6% (95% CI: 27.17%–30.0%). Being female (AOR = 1.89, 95% CI (1.17–3.06)), urban resident index cases (AOR = 1.88, 95% CI (1.16–3.03)), and having disclosure status (AOR = 2.34, 95% CI (1.40–3.92)) were significantly associated with early index case testing. Conclusion: This study examines the prevalence and key factors influencing early index case HIV testing among adult patients in Debre Markos town. By identifying critical determinants such as gender, residence, and disclosure status, it provides valuable insights into how early testing can be enhanced to reduce transmission and improve health outcomes.