Prevalence and Factors Associated with Family-Based HIV Index Case Testing in Wolaita Zone, Southern Ethiopia, 2023: A Cross-Sectional Study

ABSTRACT Background Family-based HIV index case testing identifies family members with unknown HIV status and links them to care. Data are limited in southern Ethiopia. Methods A facility-based cross-sectional study was conducted among 377 adults on antiretroviral therapy (ART) in Wolaita Zone, Southern Ethiopia, from November 2022 to May 2023. Participants were selected using systematic random sampling. Data were collected via interviewer-administered semi-structured questionnaire. Multivariable logistic regression identified factors associated with index case family testing. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and statistical significance was declared at p < 0.05. Results The proportion of index case family testing for HIV was 84.9% (95% CI: 81.2– 88.6). In multivariable analysis, urban residence (AOR = 2.8; 95% CI: 1.16–6.75), duration on ART greater than 12 months (AOR = 13.0; 95% CI: 4.6–36.9), disclosure of HIV status to family members (AOR = 5.6; 95% CI: 1.9–16.5), discussion of HIV status with family members (AOR = 6.6; 95% CI: 1.9–23.2), and being counselled by health professionals to bring families for testing (AOR = 6.3; 95% CI: 2.1–19.0) were significantly associated with index case family testing. Conclusion The prevalence of family-based HIV index case testing in Wolaita Zone was 84.9%, below the national 95% target. Health professionals should strengthen counselling on ART adherence, status disclosure, family discussion, and active referral to improve testing uptake among family members of people living with HIV.