Human Immunodeficiency Virus (HIV) continues to be a major global health challenge. Each day, around 4,100 people acquire the virus; if the current trend persists, 1.2 million people will have HIV in 2025, which is three times more than the target of 370,000 new infections for the same year(1, 2).
There were an estimated 39.0 million [33.1–45.7 million] people living with HIV at the end of 2022, two-thirds of whom (25.6 million) are in the WHO African Region (3).
Ethiopia is the second most populous country in Sub-Saharan Africa, with an estimated population of around 103,389,414 divided amongst approximately 80 ethnic groups (4).The HIV situation in Ethiopia is characterized by a low-intensity, mixed epidemic with significant heterogeneity across geographic areas (5). The epidemic has different prevalence rates from region to region; about three- fourths of People living with HIV (PLHIV) are from Amhara, Oromia and Addis Ababa (6, 7).
Nevertheless, the rapid expansion of the Anti-retrovirus treatment (ART) program in Ethiopia led to a significant decline in the number of acquired immunodeficiency syndrome (AIDS) deaths from 117.7/100,000 in 2001 to 11.73/100,000 in 2019, and 79% of estimated PLHIVs knew their status, 90% were on ART while 91% were virally suppressed as of December 2019 (8).
A robust national surveillance system is a prerequisite for monitoring the attainment and sustainment of HIV epidemic control as countries scale up their HIV responses toward universal access (9).
HIV case surveillance is a key element of second-generation surveillance that provides high-quality, timely, and reliable geographically granular data by population characteristics (10)
It is unlikely that the HIV targets set for 2030 will be achieved if countries rely only on existing HIV knowledge, technologies and service delivery approaches (11). So, using innovation to expand services to better address people’s needs, perspectives and focus on the locations and populations with the highest HIV burden is not choice but it is must (12).
Antibody-based tests for recent infection are among these innovations that measure biomarkers detected in the early phase of HIV infection. These tests distinguish recent infection from long-term infection and have been used to measure the impact of HIV prevention and control efforts and to estimate population-level HIV incidence for the past two decades (13).
The identification and quantification of recent infections can aid in HIV surveillance by providing a more accurate picture of new transmission incidents, enabling public health officials to pinpoint clusters and geographical hotspots of recent HIV transmission, perform contact tracing and facilitate programmatic intervention and efficient allocation of limited resources (14, 15).
People with a recent HIV infection may be more likely to transmit HIV to others due to high levels of viruses in their bodies at that time. Early identification and initiation of treatment in individuals with a recent HIV infection is essential for their health and quality of life (16).
Ethiopia has started to implement HIV Case Surveillance along with recency testing in all regions, including Oromia since June 2019, as part of the global commitment to combat HIV (17). However, the data gathered through this initiative was not thoroughly analyzed and used for the responses accordingly.
Therefore, this study assessed recent HIV-1 Infection epidemiological trends and associated factors among newly identified positives in Oromia, Ethiopia, using HIV Case Surveillance data (2019-2022).
General objective
To assess recent HIV-1 Infection epidemiological trends and associated factors among newly identified positives in Oromia, Ethiopia, using HIV Case Surveillance data (2019-2022).
Specific Objectives:
➢ To assess the epidemiological trends of recent infections
➢ To describe the proportions of recent and long-term infections.
➢ To identify risk factors associated with recent infections.