{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T20:31:48Z","timestamp":1776457908839,"version":"3.51.2"},"posted":{"date-parts":[[2023,11,8]]},"group-title":"HIV\/AIDS","reference-count":41,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2023,11,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec id=\"s45\">\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Advanced HIV in young people living with HIV is an increasingly pressing public health issue in sub-Saharan Africa. Despite global progress in early HIV testing and reducing HIV-related deaths, many young people with HIV continue to experience HIV disease progression in sub-Saharan Africa. This study provides an overview of the prevalence, clinical manifestations, and factors associated with advanced HIV in young people seeking medical services in a major hospital in Sierra Leone.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec id=\"s46\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used a cross-sectional design to collect data from HIV patients aged 15 to 24 years at a major hospital in Sierra Leone between September 2022 and March 2023. Advanced HIV was defined as (i) CD4+ below 200 cells\/mm3 or (ii) WHO clinical stage 3 or 4. Logistic regression models determined the association between observable independent characteristics and advanced HIV. The statistical significance level was set at 0.05 for all statistical tests.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec id=\"s47\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>About 40% (231\/574) of patients were recruited; 70.6% (163\/231) were inpatients, and 29.4% (68\/231) were outpatients. The mean age was approximately 21.6 years (SD \u00b12.43). The overall prevalence of advanced HIV was 42.9% (99\/231), 51.5% (35\/68) of outpatients, and 39.3% (64\/163) of inpatients. Age of inpatients (OR, 1.23; 95% CI, 1.00-1.52; p= 0.047) was associated with a higher risk. Female sex (OR, 0.51; 95% CI, 0.28-0.94; p= 0.030), higher education (OR, 0.27; 95% CI, 0.10 \u2013 0.78; p= 0.015), and Body Mass (OR, 0.10; 95% CI, 0.01-0.77; p= 0.028) were at lower risk of advance HIV. Common conditions diagnosed in this population are tuberculosis (13.58%), hepatitis B (6.13%), Kaposi sarcoma (3.07%), and esophageal candidiasis (2.45%).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec id=\"s48\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We reported a high prevalence of advanced HIV among young patients in a referral Hospital in Sierra Leone. This emphasises the need to strengthen public health measures and policies that address challenges of access to HIV services.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec id=\"s49\">\n                  <jats:title>Strengths and limitations of this study<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>This is the first study in Sierra Leone and the sub-region to examine the burden of advanced HIV and its predictors in young people living with HIV.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Calls for a more targeted approach to addressing gaps in health service delivery for young people living with HIV in Sierra Leone.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>The study is limited by the unavailability of several laboratory investigations to monitor patient progress.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>","DOI":"10.1101\/2023.11.07.23296880","type":"posted-content","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T13:45:22Z","timestamp":1699451122000},"source":"Crossref","is-referenced-by-count":3,"title":["Prevalence and factors associated with advanced HIV disease among young people aged 15 - 24 years in a national referral hospital in Sierra Leone: A cross-sectional study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7772-1111","authenticated-orcid":false,"given":"Mamadu","family":"Baldeh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2413-0398","authenticated-orcid":false,"given":"Samuel","family":"Kizito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7639-0004","authenticated-orcid":false,"given":"Sulaiman","family":"Lakoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frida","family":"Dennis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umu","family":"Barrie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel Adeyemi","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9772-3533","authenticated-orcid":false,"given":"Dimbintsoa Rakotomalala","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franck","family":"Lamontagne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franck","family":"Amahowe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Turay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7230-0438","authenticated-orcid":false,"given":"Ozge","family":"Sensory-Bahar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-1424","authenticated-orcid":false,"given":"Elvin","family":"Geng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-5650","authenticated-orcid":false,"given":"Fred M.","family":"Ssewamala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2023111102550512000_2023.11.07.23296880v1.1","unstructured":"HIV [Internet]. 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