Nevertheless, in the multivariate regression analysis, fatigue was significantly (p <  0.05) associated with parity [AOR = 2.01; 95% CI: 1.09–3.71], CD4 cell count [AOR = 2.81; 95% CI: 1.58–4.99], anemia [AOR = 4.90 95% CI: 2.40–9.97], current WHO classification of HIV disease [AOR = 3.11; 95% CI: 1.51–6.40], depression [AOR = 3.68 95% CI: 1.99–6.79], and co-morbidities [AOR = 3.65; 95% CI: 1.71–7.78] (Table 5). Here, CD4 is linked to major depressive disorder.