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HIV in Lebanon: Reasons for Testing, Engagement in Care, and Outcomes in Patients with Newly Diagnosed HIV Infections

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Abstract

Little is known about clinical presentation and cascade of care among patients living with HIV (PLWH) in Beirut, Lebanon. The study aims to examine the reasons for HIV testing and to evaluate the clinical characteristics of, predictors of advanced HIV stage at presentation in, and rates of ART initiation, retention in care, and viral load suppression among PLWH in Lebanon. We conducted a retrospective study of PLWH presenting to a tertiary-care centre-affiliated outpatient clinic from 2008 to 2016 with new HIV infection diagnoses. We identified a total of 423 patients: 89% were men, 55% were 30–50 years old, and 58% self-identified as men who have sex with men. About 35% of the patients had concurrent sexually transmitted diseases at the time of HIV diagnosis. Thirty percent of infection cases were identified by provider-initiated HIV testing, 36% of cases were identified by patient-initiated testing, and 34% of patients underwent testing for screening purposes. The proportion of individuals presenting with advanced HIV disease decreased from 40% in 2008–2009 to 24% in 2014–2015. Age older than 50 years and identification of HIV by a medical provider were independent predictors of advanced HIV infection at presentation. Among patients having indications for treatment (n = 253), 239 (94%) were prescribed antiretroviral therapy, and 147 (58%) had evidence of viral suppression at 1 year. Furthermore, 266 patients (63%) were retained in care. The care continuum for PLWH in Lebanon is comparable with those in high-income countries yet still far behind the Joint United Nations Programme on HIV/AIDS 90–90–90 set target.

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Funding

Not applicable. This research was not funded.

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Author notes

  1. Rita Wilson Dib and Dima Dandachi should be considered joint first authors.

Authors and Affiliations

  1. Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Rita Wilson Dib & Dima Dandachi

  2. Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA

    Dima Dandachi & Thomas P. Giordano

  3. Division of Infectious Diseases, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon

    Mireille Matar

  4. Department of Medicine, Division of Infectious Diseases, Lebanese American University School of Medicine, Beirut, Lebanon

    Annoir Shayya & Jacques E. Mokhbat

  5. Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA

    Jessica A. Davila & Thomas P. Giordano

  6. Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA

    Jessica A. Davila & Thomas P. Giordano

  7. Division of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA

    Rita Wilson Dib

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  1. Rita Wilson Dib
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Correspondence to Rita Wilson Dib.

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Wilson Dib, R., Dandachi, D., Matar, M. et al. HIV in Lebanon: Reasons for Testing, Engagement in Care, and Outcomes in Patients with Newly Diagnosed HIV Infections. AIDS Behav 24, 2290–2298 (2020). https://doi.org/10.1007/s10461-020-02788-3

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  • DOI: https://doi.org/10.1007/s10461-020-02788-3

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