Time to Virological failure and it's predictor among HIV positive clients with the differentiated service delivery model of HIV at Debre Berhan Comprehensive Specialized Hospital, Amhara Regional state, Ethiopia, 2021: A retrospective cohort study.

Diversified Anti-Retroviral Therapy (ART) approach is needed in methods that were acceptable to communities and maintain good viral suppression outcomes in order to reach the UNAIDS targets to end the HIV/AIDS epidemic by 2030. Ethiopia is fully implementing differentiated service delivery approaches, appointment spacing, and standard care. This study aimed to determine the time to HIV virological failure and its predictors among patients with a differentiated service delivery model. An institution-based retrospective cohort study was conducted with data collection dates ranging from May 1-30, 2021. All adult HIV positive patients (n = 2148) between January 2018 and January 2021 were a source population. Data was extracted using a standard check list by trained data collectors and entered into Epi Data, exported to SPSS version 20 for data management, and then exported to R Studio version 1.4 for analysis. Kaplan-Meier survival curves, the log-rank test, and Cox proportional hazard regression models were employed. The incidence of virologic failure was 86 per 10,000 person-months. The independent predictors for the hazard of Virological failure were being on standard care (AHR = 1.91; 95% CI (1.07 - 3.40)), primarily educated (AHR = 3.46; 95% CI (1.02 - 11.72)), having no education (AHR = 3.45; 95% CI (1.01 - 11.85)), ambulatory status at baseline (AHR = 1.81; 95% CI (1.06 - 3.09)). Patients who had a viral load with a detectable range from 50-999 at engagement (AHR = 2.65; 95% CI (1.33 - 5.27)) and a one-month increase in ART for HIV patients (AHR = 1.045; 95% CI (1.01-1.09)). The incidence of virologic failure was 86 per 10,000 person-months, while the incidences were 52 per 10,000 and 71 per 10,000 person months on ASM and standard care, respectively, with independent predictors: patient category, educational status, baseline functional status, viral load at engagement, and duration of ART.