Auditing HIV-Related Deaths Using the Three-Delay Framework: Evidence from Lubumbashi, in Democratic Republic of Congo
Mbayo Lukasu Xavier, Kabamba Temple, Kadiebwue Mulumba, Kasonga Kasonga, Nduaya Ngalamulume, Kabeya Mulembe, Tunsele Kasonga, Muanangoyi Crispin, Kitolo Safi, Tshoto Kabilu, Abel Nkongolo, Mukendi Richard
Asian Journal of Medical Principles and Clinical Practice · pp. 363–372 · Published 2 Apr 2026
10.9734/ajmpcp/2026/v9i1407Abstract
Background: HIV-related mortality remains high in sub-Saharan Africa despite expanded access to antiretroviral therapy. This study aimed to audit HIV-related deaths using the three-delay model and assess its impact on achieving UNAIDS “95-95-95” and WHO mortality targets. Methods: We conducted a retrospective descriptive audit of 159 hospitalized adults living with HIV at Jason Sendwe Provincial Hospital, Lubumbashi, from January to December 2024. Data were analyzed to identify delays in care and their association with mortality. Results: In-hospital mortality was 33.3%. The first delay (care-seeking) and third delay (treatment interruption and unsuppressed viral load) were strongly associated with death (PR = 6.8 and PR = 5.5, respectively). Over half of the deceased patients had unsuppressed viral load, and 22.5% had interrupted ART, undermining UNAIDS targets. Conclusion: Addressing delays in care, particularly treatment continuity, is essential to reducing HIV-related mortality and achieving global targets in resource-limited settings.
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