Table 3.
Bivariate | Multivariable Model 1 (N=1171)b | Multivariable Model 2 (N=1174)c | ||
---|---|---|---|---|
n | OR (95% CI) | aOR (95% CI) | aOR (95% CI) | |
Predisposing factors | ||||
Sex (ref: non-pregnant women, n=669) | ||||
Men | 458 | 2.34 (1.81 to 3.03) | 2.29 (1.73 to 3.02) | 2.02 (1.50 to 2.73) |
Pregnant women | 53 | 0.44 (0.19 to 1.00) | 0.41 (0.18 to 0.97) | 0.53 (0.21 to 1.33) |
Age at ART initiation (ref: 18 to 29, n=374) | ||||
30 to 39 | 482 | 1.63 (1.21 to 2.19) | 1.27 (0.92 to 1.75) | 1.25 (0.88 to 1.77) |
40 to 49 | 238 | 1.29 (0.90 to 1.85) | 0.91 (0.61 to 1.35) | 0.92 (0.60 to 1.40) |
50 + | 86 | 1.14 (0.67 to 1.93) | 0.72 (0.41 to 1.26) | 0.60 (0.33 to 1.10) |
Education level (ref: primary school or vocational/other, n=484) | ||||
No school | 374 | 0.78 (0.57 to 1.05) | ||
Secondary school | 239 | 1.09 (0.78 to 1.51) | ||
University | 83 | 1.16 (0.71 to 1.91) | ||
Relationship status (ref: in a relationship, n=673) | ||||
Not in a relationship | 507 | 1.15 (0.90 to 1.48) | ||
Has ever had children (ref: no, n=253) | ||||
Yes | 926 | 0.78 (0.58 to 1.05) | ||
Alcohol use (ref: low or none, n=916) | ||||
High | 162 | 1.59 (1.12 to 2.26) | ||
Moderate | 102 | 1.06 (0.68 to 1.67) | ||
Psychological distress (ref: low or none, n=480) | ||||
Medium | 348 | 1.93 (1.41 to 2.66) | 1.76 (1.27 to 2.46) | 1.61 (1.12 to 2.31) |
High | 347 | 2.91 (2.08 to 4.07) | 2.70 (1.90 to 3.85) | 1.96 (1.34 to 2.87) |
Enacted stigma (ref: none, n=983) | ||||
Any | 192 | 1.05 (0.74 to 1.48) | ||
Internalized stigma (ref: top tercile/least stigma, n=469) | ||||
Bottom tercile (=most stigma) | 395 | 1.44 (1.06 to 1.94) | ||
Middle tercile | 310 | 1.24 (0.90 to 1.70) | ||
History of holy water use for HIV (ref: no, n=840) | ||||
Yes | 189 | 0.69 (0.48 to 0.99) | ||
Treatment beliefs (ref: low accuracy, n=118) | ||||
High accuracy | 1061 | 0.86 (0.56 to 1.32) | ||
Enabling factors | ||||
Area of residence (ref: rural, n=259) | ||||
Urban | 920 | 0.79 (0.59 to 1.07) | ||
Trouble satisfying food needs in last year (ref: never, n=422) | ||||
Sometimes | 502 | 0.91 (0.68 to 1.22) | ||
Often | 252 | 0.84 (0.59 to 1.19) | ||
Knows someone on ART (ref: no, n=368) | ||||
Yes | 809 | 0.73 (0.56 to 0.95) | 0.77 (0.57 to 1.04) | |
Number of people disclosed to (ref: 0, n=167) | ||||
1 | 422 | 0.79 (0.55 to 1.15) | 1.00 (0.67 to 1.49) | |
≥ 2 | 591 | 0.57 (0.40 to 0.82) | 0.69 (0.46 to 1.02) | |
Social support (ref: bottom quarter/least support; n=298) | ||||
Second quarter | 305 | 0.91 (0.64 to 1.28) | ||
Third quarter | 292 | 0.84 (0.59 to 1.19) | ||
Top quarter (= most support) | 285 | 0.90 (0.62 to 1.30) | ||
Communication barriers with providers (ref: no, n=1127) | ||||
Yes | 53 | 2.27 (1.30 to 3.97) | 2.43 (1.32 to 4.48) | 2.42 (1.24 to 4.75) |
Perceived need | ||||
Tested for HIV because partner sick/dead/HIV+ (ref: no, n=930) | ||||
Yes | 250 | 0.38 (0.27 to 0.55) | 0.47 (0.32 to 0.69) | 0.64 (0.42 to 0.95) |
Clinical characteristics | ||||
Enrolment point of entry (ref: VCT, n=493) | ||||
PMTCT | 45 | 0.31 (0.11 to 0.88) | – | 0.56 (0.18 to 1.72) |
PITC | 491 | 1.80 (1.36 to 2.39) | – | 1.47 (1.07 to 2.04) |
Other, including TB clinic | 32 | 2.15 (1.03 to 4.49) | – | 1.85 (0.73 to 4.71) |
Unknown | 119 | 2.22 (1.45 to 3.42) | – | 1.70 (1.04 to 2.77) |
History of TB treatment in HIV care (ref: no, n=1030) | ||||
Yes | 150 | 2.93 (2.07 to 4.16) | – | 2.16 (1.43 to 3.25) |
Gap in care of six months or more prior to ART (ref: no, n=260) | ||||
Yes | 260 | 2.41 (1.35 to 4.33) | – | 2.02 (1.10 to 3.72) |
Initiated ART during first six months in care | 659 | 11.64 (7.04 to 19.25) | – | 8.98 (5.34 to 15.08) |
aOR, adjusted odds ratio; ART, antiretroviral therapy; OR, odds ratio; VCT, voluntary counselling and testing; PMTCT, prevention of mother-to-child transmission; PITC, provider-initiated testing and counselling; TB, tuberculosis
late ART initiation is defined as having a CD4+ cell count <150 cells/µL or WHO Stage IV. Analyses account for site-level clustering. Statistically significant associations (p<0.05) in bold
multivariable Model 1 includes only psychosocial factors
multivariable Model 2 is final, combining psychosocial and clinical factors.