Determinants of Late Initiation in Anti-retroviral Therapy Among HIV Positive Adult Patients in Public Health Facilities, West Guji Zone, Oromia, Ethiopia: A Case Control Study.

ObjectiveThis study aimed to identify determinants of late ART initiation among adults living with HIV in public health facilities of West Guji Zone, Oromia, Ethiopia.MethodsUnmatched case-control study was conducted among 226 adults living with HIV (113 cases and 113 controls) selected by simple random sampling. Data was collected using an interviewer-administered questionnaire and analyzed using SPSS version 25. Multivariable logistic binary regression was used to identify determinants of late ART initiation.ResultsLate ART initiation was associated with inability to read and write (AOR = 6.21, 95% CI: 2.32-7.98), rural residence (AOR = 4.26, 95% CI: 1.23-14.74), fear of job loss (AOR = 8.43, 95% CI: 6.72-20.05), lack of family support (AOR = 7.28, 95% CI: 1.90-12.19), absence of intention to protect family members (AOR = 6.16, 95% CI: 4.15-12.97), visiting traditional healers (AOR = 5.24, 95% CI: 1.51-13.40), and contact with commercial sex workers (AOR =5.59, 95% CI: 4.07-13.80).ConclusionsDelayed ART initiation was driven by interacting sociodemographic, psychosocial, and behavioral factors. Addressing social disadvantages, fear-related concerns, weak family support, and reliance on non-formal care pathways is essential to promote timely initiation of ART.