Delayed presentation for human immunodeficiency virus (HIV) care among veterans - A problem of access or screening?
Delayed presentation for human immunodeficiency virus (HIV) care among veterans - A problem of access or screening?
复制标题
DOI：
10.1097/mlr.0b013e3181271476
复制
发表时间：
2007-11-01
期刊：
影响因子：
3
通讯作者：
Justice, Amy C.
中科院分区：
文献类型：
--
作者：
Gandhi, Neel R.;Skanderson, Melissa;Justice, Amy C.
背景：尽管抗逆转录病毒治疗有效，但进入人类免疫缺陷病毒(HIV)治疗的患者中，近一半患有晚期疾病。许多人将这种延迟归因于获得医疗保健的机会很少。其他人认为，在采用常规筛查之前，延误将持续下去。退伍军人健康管理局(VA)是检验获得综合医疗福利是否会导致更早进入HIV护理的唯一实验室。方法：对1998-2002年在VA医疗中心进入HIV护理的4368名HIV阳性患者进行回顾性观察研究。感兴趣的结果：出现的年份中获得性免疫缺陷综合征的发生率；在出现HIV之前使用VA的持续时间；在出现之前存在的“临床触发因素”，表明更大的HIV感染风险。结果：所有出现CD4计数的患者中有51%(n=2211)
Background: Despite the effectiveness of antiretroviral therapy, nearly half of patients entering human inummodeficiency virus (HIV) care have advanced disease. Many attribute this delay to poor access to healthcare. Others argue that delays will persist until routine screening is adopted. The Veterans Health Administration (VA) is a unique laboratory to examine whether access to comprehensive health benefits results in earlier entry into HIV care.Methods: Retrospective observational study of 4368 HIV-positive patients entering HIV care during 1998-2002 at VA medical centers nationwide. Outcomes of interest: rates of acquired immune deficiency syndrome in year of presentation; duration of VA utilization before HIV presentation; presence of "clinical triggers," signaling greater risk of HIV infection, before presentation.Results: Fifty-one percent (n = 2211) of all patients presented with CD4 counts of