Determinants of delayed diagnosis of HIV infection in France, 1993-1995
Determinants of delayed diagnosis of HIV infection in France, 1993-1995
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DOI：
10.1097/00002030-199807000-00016
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发表时间：
1998-05-07
期刊：
影响因子：
3.8
通讯作者：
Brunet, JB
中科院分区：
文献类型：
--
作者：
Couturier, E;Schwoebel, V;Brunet, JB
目的：描述首次 HIV 阳性检测的情况，并研究 HIV 感染延迟诊断的决定因素。方法：在法国两个地区 1993 年 7 月至 1995 年 5 月之间诊断的成年艾滋病患者的回顾性研究中，通过保密访谈收集了有关社会经济特征、首次 HIV 阳性检测的情况以及对医疗保健的态度和行为的数据，并分析了与延迟检测（定义为艾滋病后 6 个月内首次 HIV 阳性检测）的潜在关联。结果：在研究的 359 名艾滋病患者中，69 名 (19.2%) 进行了较晚的检测。较晚的测试者比其他患者更有可能因临床症状而进行 HIV 阳性测试（89.7% vs 38.9%，P < 0.001），并且不认为自己有感染 HIV 的风险（53.6 vs 39.3%，P < 0.05）。异性恋感染者中迟到检测者的比例为34.6%，同性恋/双性恋男性中为12.7%，注射吸毒者中为9.6%。与延迟测试独立相关的因素是男性[调整后的优势比（aOR），5.6；异性恋感染患者的 95% 置信区间 (CI)，1.7-18.9] 和缺乏收入（aOR，5.2；95% CI，1.4-19）；受过高等教育（aOR，3.1；95% CI，1.0-9.6），并咨询过同性恋/双性恋男性中的替代医学实践者（aOR，3.4；95% CI，1.2-10）。 结论：尽管有动机进行艾滋病毒检测，但法国许多人仍然检测得太晚，即使他们属于已知的高危人群。应通过提高对艾滋病毒风险的认识并减少错失检测机会的程度，努力尽早对艾滋病毒感染者进行检测。从公共卫生和个人角度来看，当前的病例管理方法使这一建议变得至关重要。 (C) 1998 年利平科特-乌鸦出版社。
Objective: To describe the circumstances of the first HIV-positive test and to study the determinants of a delayed diagnosis of HIV infection.Methods: In a retrospective study among adult AIDS patients diagnosed between July 1993 and May 1995 in two French districts, data on socioeconomic characteristics, circumstances of first HIV-positive test and attitudes and behaviours regarding medical care were collected in a confidential interview and analysed for potential association with a late test, defined as a first HIV-positive test within 6 months of AIDS diagnosis.Results: Of the 359 AIDS patients studied, 69 (19.2%) had a late test. Late testers were more likely than other patients to have had an HIV-positive test because of clinical symptoms (89.7 versus 38.9%, P < 0.001) and not to perceive themselves as being at risk of infection with HIV (53.6 versus 39.3%, P < 0.05). The proportion of late testers was 34.6% among heterosexually infected patients, 12.7% among homo-/bisexual men and 9.6% among injecting drug users. Factors independently associated with a late test were male gender [adjusted odds ratio (aOR), 5.6; 95% confidence interval (CI), 1.7-18.9] and absence of earned income (aOR, 5.2; 95% CI, 1.4-19) among heterosexually infected patients; high education (aOR, 3.1; 95% CI, 1.0-9.6) and having consulted a person practising alternative medicine (aOR, 3.4; 95% CI, 1.2-10) in homo-/bisexual men.Conclusions: Despite incentives to be tested for HIV, many individuals in France are still tested too late, even if they are in known high-risk groups. Efforts to test HIV-infected people as early as possible should be made by increasing the perception of HIV risk and decreasing the level of missed opportunities for testing. Current case management approaches make this recommendation critically important from both public health and an individual perspective. (C) 1998 Lippincott-Raven Publishers.