Please use this identifier to cite or link to this item: http://dl.umsu.ac.ir/handle/Hannan/27464
Title: Risk Factors for Late-Stage HIV Disease Presentation at Initial HIV Diagnosis in Durban, South Africa
Authors: Drain, Paul;Losina, Elena;Parker, Gary;Giddy, Janet;Ross, Douglas;Katz, Jeffrey Neil;Coleman, Sharon M.;Bogart, Laura M.;Freedberg, Kenneth A.;Walensky, Rochelle P.;Bassett, Ingrid Valerie
subject: HIV;HIV clinical manifestations;HIV epidemiology;Biology;Population Biology;Epidemiology;infectious disease epidemiology;Medicine;global health;Infectious Diseases;Viral Diseases;Retrovirology;HIV immunopathogenesis;HIV diagnosis;HIV management
Year: 2013
Publisher: Public Library of Science
Description: Background: After observing persistently low CD4 counts at initial HIV diagnosis in South Africa, we sought to determine risk factors for late-stage HIV disease presentation among adults. Methods: We surveyed adults prior to HIV testing at four outpatient clinics in Durban from August 2010 to November 2011. All HIV-infected adults were offered CD4 testing, and late-stage HIV disease was defined as a CD4 count \(<100 cells/mm^{3}\). We used multivariate regression models to determine the effects of sex, emotional health, social support, distance from clinic, employment, perceived barriers to receiving healthcare, and foregoing healthcare to use money for food, clothing, or housing (“competing needs to healthcare”) on presentation with late-stage HIV disease. Results: Among 3,669 adults screened, 830 were enrolled, newly-diagnosed with HIV and obtained a CD4 result. Among those, 279 (33.6%) presented with late-stage HIV disease. In multivariate analyses, participants who lived ≥5 kilometers from the test site [adjusted odds ratio (AOR) 2.8, 95% CI 1.7–4.7], reported competing needs to healthcare (AOR 1.7, 95% CI 1.2–2.4), were male (AOR 1.7, 95% CI 1.2–2.3), worked outside the home (AOR 1.5, 95% CI 1.1–2.1), perceived health service delivery barriers (AOR 1.5, 95% CI 1.1–2.1), and/or had poor emotional health (AOR 1.4, 95% CI 1.0–1.9) had higher odds of late-stage HIV disease presentation. Conclusions: Independent risk factors for late-stage HIV disease presentation were from diverse domains, including geographic, economic, demographic, social, and psychosocial. These findings can inform various interventions, such as mobile testing or financial assistance, to reduce the risk of presentation with late-stage HIV disease.
URI: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557232/pdf/
http://nrs.harvard.edu/urn-3:HUL.InstRepos:10613686
Standard no: Drain, Paul, Elena Losina, Gary Parker, Janet Giddy, Douglas Ross, Jeffrey Neil Katz, Sharon M. Coleman, and et al. 2013. Risk factors for late-stage HIV disease presentation at initial HIV diagnosis in Durban, South Africa. PLoS ONE 8(1): e55305.
1932-6203
Appears in Collections:HMS Scholarly Articles

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