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 > or = 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.
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/AIDSOutpatient 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 > or = 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.
Authors: W Cavert; D W Notermans; K Staskus; S W Wietgrefe; M Zupancic; K Gebhard; K Henry; Z Q Zhang; R Mills; H McDade; C M Schuwirth; J Goudsmit; S A Danner; A T Haase Journal: Science Date: 1997-05-09 Impact factor: 47.728
Authors: M S Cohen; I F Hoffman; R A Royce; P Kazembe; J R Dyer; C C Daly; D Zimba; P L Vernazza; M Maida; S A Fiscus; J J Eron Journal: Lancet Date: 1997-06-28 Impact factor: 79.321
Authors: H Grosskurth; F Mosha; J Todd; E Mwijarubi; A Klokke; K Senkoro; P Mayaud; J Changalucha; A Nicoll; G ka-Gina Journal: Lancet Date: 1995-08-26 Impact factor: 79.321
Authors: Barbara S Taylor; L Sergio Garduño; Emily V Reyes; Raziel Valiño; Rita Rojas; Yeycy Donastorg; Karen Brudney; Jennifer Hirsch Journal: Mt Sinai J Med Date: 2011 May-Jun
Authors: Sandra I McCoy; William C Miller; Pia D M MacDonald; Christopher B Hurt; Peter A Leone; Joseph J Eron; Ronald P Strauss Journal: AIDS Care Date: 2009-10
Authors: Craig M Hooker; Robert A Meguid; Alicia Hulbert; Joshua T Taylor; James Shin; John Wrangle; Kristen Rodgers; Beverly Lee; Suvasini Laskshmanan; Travis Brown; Avedis Meneshian; Marc Sussman; Jeanne Keruly; Richard D Moore; Stephen C Yang; Malcolm V Brock Journal: Ann Thorac Surg Date: 2012-02 Impact factor: 4.330
Authors: James L Harmon; Michelle Collins-Ogle; John A Bartlett; Julie Thompson; Julie Barroso Journal: J Assoc Nurses AIDS Care Date: 2013-04-09 Impact factor: 1.354