Abstract:
Background: Despite significant advancements in antiretroviral therapy
(ART), HIV/AIDS continues to be a critical health challenge in Meru
County, Kenya, particularly regarding the high mortality rates among
people living with HIV (PLHIV). This study aimed to fit a survival model
for predicting mortality and evaluate survival differences among adult
HIV/AIDS patients under ART at Meru Teaching and Referral Hospital
(MTRH).
Method: A retrospective cohort design was adopted, using secondary data
from MTRH for all HIV-positive adults who received ART between January 1, 2018, and December 31, 2023. The target population comprised
patients with complete medical records available for analysis. Collected data
included demographic, socioeconomic, and clinical variables, with mortality
as the event of interest. Data were de-identified to ensure privacy and
analyzed using R statistical software. The quantitative analysis employed
the Cox Proportional Hazards regression model to fit a survival model
for predicting mortality. The Log-rank test evaluated survival differences
among PLHIV across different treatment groups.
Results: Results indicated that gender and age were significant predictors
of mortality. Specifically, being male was associated with a 72% higher
hazard of mortality compared to females (exp(coef) = 1.718), and each
additional year of age increased the hazard by 1.5% (coefficient = 1.015).
However, smoking status and employment were not significantly associated
with mortality. The Log-rank test revealed a significant difference in survival
rates between male and female participants (χ2 = 4.1, df = 1, p = 0.04), with
females showing better survival outcomes, while no significant differences
were found based on age, smoking status, or marital status.
Conclusion: The study concluded that gender and age are key determinants
of mortality among PLHIV under ART at MTRH, with males facing
higher mortality risks. The findings emphasize the need for gender-sensitive
healthcare interventions and age-appropriate care strategies to improve
survival outcomes. Further research is recommended to explore the specific
challenges faced by male PLHIV and to investigate the broader impact of
socioeconomic factors on survival outcomes.
