Correlates of late HIV diagnosis: implications for testing policy
Correlates of late HIV diagnosis: implications for testing policy
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DOI：
10.1258/095646207780749709
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发表时间：
2007-05-01
影响因子：
1.4
通讯作者：
Lert, France
中科院分区：
文献类型：
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作者：
Delpierre, Cyrille;Dray-Spira, Rosemary;Lert, France
为了制定旨在减少寻求HIV诊断延误的新策略，我们建议在法国确定HIV感染晚期诊断的相关因素。研究人员对1996年诊断的1077名患者进行了晚期检测，这些患者被纳入了ANRS-EN12-VESPA，这是法国艾滋病毒感染人群的代表性样本。如果患者在诊断时出现临床艾滋病事件或CD4细胞计数< 200/mm(3)，则将其定义为“晚期检测者”。总共有33.1%的人被归类为晚期检测者，其中42.6%的人在艾滋病事件发生时发现了自己的艾滋病毒感染。这一比例随着年龄的增长而增加，在异性恋男性和移民中比例更高。在非移民异性恋人群中，晚期诊断在有孩子的长期伴侣中更为常见，而在有大量性伴侣的人群中则不太可能。在诊断前领取福利与较低的晚期诊断风险相关。在移民中，缺乏近期稳定的伴侣关系与风险增加有关，因为在法国停留的第一年就被诊断出来了。我们的结果显示，感染的低危险因素是晚期检测的危险因素。公共宣传应旨在提高同性恋和异性恋人群中有稳定工作的长期伴侣对艾滋病毒风险的认识。在移徙者中，应改进入境后不久经知情同意进行的艾滋病毒检测，特别是对非夫妻的个人。
To develop new strategies aimed to reduce the delay in seeking HIV diagnosis, we proposed to identify correlates of late diagnosis of HIV infection in France. Late testing was studied among the 1077 patients diagnosed from 1996 and enrolled in the ANRS-EN12-VESPA, a representative sample of the French HIV-infected population. Patients were defined as 'late testers' if they had presented either clinical AIDS events or CD4 cell count < 200/mm(3) at diagnosis. In all, 33.1% were classified as late testers, among whom 42.6% had discovered their HIV infection at the time of AIDS events. This proportion increased with age and was higher for heterosexual men and migrants. Among the non-migrants heterosexual population, late diagnosis was more frequent among people in longstanding couple, with children and conversely was less likely among individuals with large number of sexual partners. Being on welfare benefit before diagnosis was associated with a lower risk of late diagnosis. Among migrants, lack of recent steady partnership was associated with an increased risk, as being diagnosed during the first year of stay in France. Our results showed low risk factors of infection were risk factors of late testing. Public communication should aim at improving the awareness of HIV risk in longstanding couples with stable employment, both among homosexual and heterosexual populations. Among migrants, HIV testing with informed consent short after entry should be improved, especially towards individuals not in couple.