Late HIV diagnosis and determinants of progression to AIDS or death after HIV diagnosis among injection drug users, 33 US States, 1996-2004.
Late HIV diagnosis and determinants of progression to AIDS or death after HIV diagnosis among injection drug users, 33 US States, 1996-2004.
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DOI：
10.1371/journal.pone.0004445
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发表时间：
2009
期刊：
影响因子：
3.7
通讯作者：
Wei, Xiangming
中科院分区：
文献类型：
--
作者：
Grigoryan, Anna;Hall, H. Irene;Durant, Tonji;Wei, Xiangming
及时诊断艾滋病毒和开始抗逆转录病毒治疗是艾滋病毒感染者生存的主要决定因素。注射吸毒者（IDUs）比其他传播类别的人更不可能寻求早期艾滋病毒咨询，检测和治疗。我们的目标是估计晚期艾滋病毒诊断（艾滋病毒诊断后12个月内诊断出艾滋病）的注射吸毒者比例，并确定与艾滋病毒诊断后疾病进展相关的因素。使用来自33个州的数据，根据保密的姓名报告艾滋病毒，我们确定了1996-2004年期间年龄≥13岁的注射吸毒者中接受晚期艾滋病毒诊断的比例。我们使用标准化Kaplan-Meier生存方法，通过种族/民族、性别、年龄组、CD 4 + T细胞计数、大城市居住地和诊断年份，确定从HIV进展到AIDS和死亡的时间差异。我们比较了注射吸毒者的生存与其他传播类别的人的生存。1996-2004年期间，27 572名注射吸毒者中有42.2%（11 635人）被诊断为晚期。对于注射吸毒者，非白人、男性和老年人在艾滋病毒诊断后3年从艾滋病毒进展为艾滋病的风险更大。与通过男男性接触暴露的男性（91.6%，95% CI，91.6-91.7）和通过高风险异性性接触（HRHC）暴露的男性（91.9%，95% CI，91.8-91.9）相比，注射吸毒男性（87.3%，95% CI，87.1-87.4）在艾滋病毒诊断后的三年存活率较低。与HRHC女性（93.3%，95% CI，93.3-93.4）相比，IDU女性（89.5%，95% CI，89.4-89.6）的生存率也较低。很大一部分感染艾滋病毒的注射吸毒者很晚才得到艾滋病毒诊断。为了提高注射吸毒者的存活率，艾滋病毒预防工作必须确保抢先体验艾滋病毒检测和护理，并鼓励坚持抗逆转录病毒治疗以减缓疾病进展。
The timeliness of HIV diagnosis and the initiation of antiretroviral treatment are major determinants of survival for HIV-infected people. Injection drug users (IDUs) are less likely than persons in other transmission categories to seek early HIV counseling, testing, and treatment. Our objective was to estimate the proportion of IDUs with a late HIV diagnosis (AIDS diagnosis within 12 months of HIV diagnosis) and determine the factors associated with disease progression after HIV diagnosis. Using data from 33 states with confidential name-based HIV reporting, we determined the proportion of IDUs aged ≥13 years who received a late HIV diagnosis during 1996–2004. We used standardized Kaplan-Meier survival methods to determine differences in time of progression from HIV to AIDS and death, by race/ethnicity, sex, age group, CD4+ T-cell count, metropolitan residence, and diagnosis year. We compared the survival of IDUs with the survival of persons in other transmission categories. During 1996–2004, 42.2% (11,635) of 27,572 IDUs were diagnosed late. For IDUs, the risk for progression from HIV to AIDS 3 years after HIV diagnosis was greater for nonwhites, males and older persons. Three-year survival after HIV diagnosis was lower for IDU males (87.3%, 95% confidence interval (CI), 87.1–87.4) compared with males exposed through male-to-male sexual contact (91.6%, 95% CI, 91.6–91.7) and males exposed through high-risk heterosexual contact (HRHC) (91.9%, 95% CI, 91.8–91.9). Survival was also lower for IDU females (89.5%, 95% CI, 89.4–89.6) compared to HRHC females (93.3%, 95% CI, 93.3–93.4). A substantial proportion of IDUs living with HIV received their HIV diagnosis late. To improve survival of IDUs, HIV prevention efforts must ensure early access to HIV testing and care, as well as encourage adherence to antiretroviral treatment to slow disease progression.
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DOI：
10.1097/00126334-200402010-00010
发表时间：
2004-02-01
影响因子：
3.6
作者：
Jarlais, DCD;Perlis, T;Friedman, SR
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影响因子：
120.7
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发表时间：
2005-01-01
影响因子：
3.6
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影响因子：
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