Factors Associated with Late Engagement to HIV Care in Western Kenya: A Cross-Sectional Study

Charles Meja Kwobah, Paula Braitstein, Julius K. Koech, Gilbert Simiyu, Ann W. Mwangi, Kara Wools-Kaloustian, Abraham M. Siika

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Late presentation of patients contributes significantly to the high mortality reported in HIV -care and treatment programs in sub-Saharan Africa. Methods: A cross-sectional study was conducted to assess factors associated with late engagement to HIV care at the Academic Model Providing Access to Healthcare in western Kenya. Late engagement was defined as baseline CD4 ≤100 cells/mm3. Results: Of the 10 533 participants included in the analysis, 67% were female and mean age was 36.7 years. Overall, 23% of the participants presented late. Factors associated with late engagement included male gender (adjusted odds ratio [AOR]: 1.54, 95% confidence interval [CI]: 1.35-1.75), older age (AOR: 1.62, 95% CI: 1.02-2.56), and longer travel time to clinic (AOR: 1.18, 95% CI: 1.04-1.34). Conclusion: Nearly one-quarter of HIV-infected patients in our setting present with advanced immune suppression at initial encounter. Being male, older age, and living further away from clinic are associated with late engagement to care.

Original languageEnglish (US)
Pages (from-to)505-511
Number of pages7
JournalJournal of the International Association of Providers of AIDS Care
Issue number6
StatePublished - Nov 1 2016


  • HIV
  • advanced immune suppression
  • late presentation

ASJC Scopus subject areas

  • Immunology
  • Dermatology
  • Infectious Diseases

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