OBJECTIVES: In Ghana HIV care for PLHIV is free, however late presentation with its increased mortality and healthcare cost has been reported at some care centers. This study aimed to describe ART clinic registrants at the Eastern Regional Hospital, estimate the magnitude and determine factors associated with late presentation to guide HIV care decision-making.

METHODS:We conducted an analytic cross sectional study. Study participants were HIV diagnosed client 15 years+ registered at the Regional Hospital January 2011 – December 2012. We entered registrants’ folder numbers into Microsoft excel and reviewed 400 randomly sampled electronic medical records. Data abstracted include WHO clinical stage of infection at registration, age, sex, educational level, occupation, residence, Health Insurance status, spousal disclosure, family member disclosure, alcohol ingestion and smoking status. Excel data was exported into Stata11. Univariate analysis done described registrants and clients WHO staged 1-2 were classified as presenting early whiles WHO staged 3-4 clients termed as presenting late. Bivariate and multiple logistic regression analysis was done to determine the factors associated with late presentation for HIV care.

RESULTS:A total of 933 HIV clients registered between 2011 – 2012 in the Eastern Regional Hospital, Ghana. Seventy-two percent of study participants were females, 39% aged 30-39 years, 85.8% had below secondary education, 55% married, 86.2% employed, 77.5% Health insured and 91.3% lived in the Eastern Region. Whiles 80.8% had not disclosed their HIV status to sexual partners, 88.8% have unprotected sex. Although 63.5% presented early, 36.6% presented late for HIV care. Logistic regression analysis (95% confidence interval) showed being male (AOR=2.83, CI=1.66-4.83), out-of-pocket payment for healthcare (AOR=2.57, CI=1.49-4.46) and non-condom use (AOR=0.43, CI=0.19-0.98) during sexual-intercourse were significantly associated with late presentation.

CONCLUSIONS: Even though majority of registrants presented early, late presentation remains a significant challenge with male sex, out-of-pocket payment and non-condom use as the determinants.