Factors associated with delayed antiretroviral therapy initiation among people living with HIV: A retrospective cross-sectional study
https://doi.org/10.52235/lp.v7i4.1051
Keywords:
continuity of patient care, HIV infections, indonesia, Retrospective Studies, treatment delayAbstract
Background: Rapid initiation of antiretroviral therapy (ART) is a priority in HIV care, yet delays may occur between confirmed diagnosis, entry into care and treatment commencement. This study examined factors associated with ART initiation more than seven days after diagnosis among people living with HIV in Ogan Komering Ilir (OKI) Regency, Indonesia.
Methods: We conducted a retrospective cross-sectional analysis of 144 complete records from the December 2025 On-ART extract of the HIV/AIDS Information System (SIHA 2.1). Delayed ART initiation was defined as starting ART >7 days after HIV confirmation. Recorded demographic, clinical and service variables were examined using two-by-two comparisons and reported multivariable logistic regression estimates. Reporting used observational-study and routinely collected data guidelines.
Results: Of 144 individuals, 99 (68.8%) initiated ART within seven days and 45 (31.3%) initiated later. World Health Organization (WHO) clinical stage 3–4 was associated with delayed initiation (adjusted odds ratio [aOR] 2.618, 95% confidence interval [CI] 1.186–5.779; p=0.017), as was the recorded delayed entry-to-care category (aOR 12.624, 95% CI 3.108–51.273; p<0.001). Age, sex, recorded population group and facility type were not statistically significant in the reported model. The register-based design and inconsistencies in the timing fields limit interpretation of the linkage estimate.
Conclusion: Delayed ART initiation among individuals already recorded as receiving ART in OKI was associated with more advanced clinical stage and a recorded delay in entry to care. Audit of date fields and evaluation of post-diagnosis care pathways are warranted before drawing causal or program-effectiveness conclusions.
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