Abstract
Introduction
Cambodia has been actively fighting HIV/AIDS for 25 years, achieving the universal target of 90-90-90 since 2017, in which 84% of PLHIV were aware of their HIV status, 99% were aware of their status as being on treatment, and 97% were on treatment being virally suppressed. Significant progress has been made over the last few decades in reducing the prevalence of HIV to 0.6% in 2020. The Ministry of Health prioritizes prevention and control, aiming to eliminate new infections by 2025. This study aimed to describe the epidemiological characteristics of PLHIV on ART who died and factors associated with mortality among adult PLHIV on ART in Cambodia.
Methods
The study analyzed the data of adult PLHIV aged 15-49 years on ART in Cambodia from January 01, 2016, to December 31, 2020. The use of the ART dataset from the National Center for HIV/AIDS, Dermatology and STIs (NCHADS) was approved. In logistic regression analysis, sociodemographic variables, clinical data, and other factors were adjusted for age and sex. predictors.
Results
Among 16,516 adult PLHIV patients, 17.2% started ART in 2016 and 22.2% in 2020. The average age was 32.9 years (SD = 8.1), with 91.4% of participants aged 15-44 years. Approximately 58.9% were women, and 27.1% had a residence in Phnom Penh, the capital. The mortality rate among adult PLHIV aged 15-49 years on ART increased from 0.87% in 2016 to 0.99% in 2020. A total of 73.1% of patients were in WHO stage I at the initial visit, 16.5% were in stages III and IV, and 2.5% had TB coinfections. According to our multivariate regression analysis, patients aged 35-44 (AOR=1.64, 95% CI=1.21-2.23) and 45-49 (AOR=1.80, 95% CI=1.25-2.61) years had a greater risk of mortality than did those aged 15-24 years. There was a greater mortality rate in men than in women (AOR=1.45, 95% CI=1.20-1.76), and divorced patients had a greater mortality rate (AOR=2.05, 95% CI=1.48-2.85). Independently, among PLHIV with WHO stage III or IV disease, the AOR ranged from 2.14 to 2.98, indicating a greater risk of death than among those with WHO stage I disease at the time of their initial visit.
Conclusion
Mortality rates among adult PLHIV on ART increased between 2016 and 2020. Factors such as age at enrollment, male sex, divorced marital status, residence in different geographical zones and WHO stage III&IV disease were associated with mortality.