Factors associated with delayed initiation of HIV medical care among infected persons attending a southern HIV/AIDS clinic
Factors associated with delayed initiation of HIV medical care among infected persons attending a southern HIV/AIDS clinic
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DOI：
10.1097/01.smj.0000215639.59563.83
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发表时间：
2006-05-01
影响因子：
1.1
通讯作者：
Vermund, Sten H.
中科院分区：
文献类型：
--
作者：
Krawczyk, Christopher S.;Funkhouser, Ellen;Vermund, Sten H.
背景资料：尽管人类免疫缺陷病毒（HIV）的早期诊断和治疗提供了证明的好处，但HIV医疗护理的延迟是常见的;这些延迟尚未完全理解，特别是在美国南部。方法：我们评估了伯明翰一家艾滋病门诊的1,209名患者中延迟就诊的程度和相关特征，结果：2/5（41.2%）的患者在进展为CDC定义的AIDS后才首次接受治疗。其中，53.6%的人在接受护理前一年被诊断出感染艾滋病毒。最近的表现（2002 - 2005年），男性，年龄>= 25，医疗保险或医疗补助保险范围内，并在6个月内的艾滋病毒诊断与启动治疗后进展为艾滋病独立相关。结论：高比例的患者进入临床治疗后，经历了实质性的疾病进展。需要采取干预措施，有效改善艾滋病毒诊断和就诊的时机。
Background: Despite the proven benefits conferred by early human immunodeficiency virus (HIV) diagnosis and presentation to care, delays in HIV medical care are common; these delays are not fully understood, especially in the southern United States.Methods: We evaluated the extent of, and characteristics associated with, delayed presentation to HIV care among 1,209 patients at an HIV/AIDS Outpatient Clinic in Birmingham, Alabama between 1996 and 2005.Results: Two out of five (41.2%) patients first engaged care only after they had progressed to CDC-defined AIDS. Among these, 53.6% were diagnosed with HIV in the year preceding entry to care. Recent presentation (2002 - 2005), male sex, age >= 25, Medicare or Medicaid insurance coverage, and presentation within six months of HIV diagnosis were independently associated with initiating care after progression to AIDS.Conclusions: A high proportion of patients entered clinical care after experiencing substantial disease progression. Interventions that effectively improve the timing of HIV diagnosis and presentation to care are needed.