Factors Associated with Opportunistic Infections among HIV/AIDS Patients Attending Comprehensive Care Clinic at Mbagathi District Hospital, Nairobi County, Kenya

Abstract

HIV/AIDS remains a persistent global health challenge, particularly in developing countries, where over 35 million people are infected, with approximately 70% residing in sub-Saharan Africa. The region reports an estimated 2.1 million new HIV infections annually—equivalent to 5,700 new cases each day and approximately 1.1 million AIDS-related deaths yearly. This underscores the urgent need to manage opportunistic infections (OIs), which contribute significantly to morbidity and mortality among people living with HIV/AIDS (PLWHAs). This study aimed to determine the prevalence, types, and factors associated with OIs among HIV-positive patients attending the Comprehensive Care Clinic (CCC) at Mbagathi District Hospital in Nairobi County, Kenya. A hospital-based cross-sectional study was conducted between March and April 2019. A total of 196 HIV-positive adults aged 18 years and above were selected using systematic random sampling. Data were collected using structured questionnaires and patient file reviews. Statistical analysis included chi-square tests and multivariate logistic regression to identify associations between OIs and various factors. Findings indicated a higher prevalence of OIs among females (62.4%) and individuals aged 36–50 years (69.6%). Tuberculosis was the most prevalent infection (41.5%), with higher occurrence among individuals reporting multiple sexual partners. The divorced/separated group showed the highest OI prevalence (75.8%). Significant associations were observed between OIs and age (p=0.003), income (p=0.0001), and ARV treatment duration (p=0.041). Other contributing factors included alcohol and drug use, low CD4 counts, non-adherence to ART, and failure to use condoms. In conclusion, socio-demographic, behavioral, and clinical factors play a critical role in the occurrence of OIs among PLWHAs. The study recommends enhanced public health interventions focusing on health education, improved ART adherence, early diagnosis of OIs, and strengthened primary healthcare systems. Collaborative efforts among health stakeholders are essential in reducing the burden of OIs and improving patient outcomes.