https://scholars.lib.ntu.edu.tw/handle/123456789/535363
標題: | Late diagnosis of human immunodeficiency virus infection in the era of highly active antiretroviral therapy: Role of socio-behavioral factors and medical encounters | 作者: | Lo Y.-C. Wu P.-Y. Hsieh C.-Y. Chen M.-Y. WANG-HUEI SHENG SZU-MIN HSIEH HSIN-YUN SUN Liu W.-C. CHIEN-CHING HUNG SHAN-CHWEN CHANG |
公開日期: | 2011 | 出版社: | Elsevier B.V. | 卷: | 110 | 期: | 5 | 起(迄)頁: | 306-315 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Despite provision of free-of-charge human immunodeficiency virus (HIV) care and antiretroviral therapy in Taiwan, a substantial proportion of patients experience late HIV diagnosis. We investigated the risk factors for late HIV diagnosis in Taiwan. Methods: Structured interviews were conducted among newly diagnosed HIV-infected patients to collect data on demographics, socio-behavioral variables and clinical profiles within 1 year preceding HIV diagnosis from August 2006 to July 2008. Multivariate analysis was performed to identify factors associated with missed opportunities for HIV testing and late HIV diagnosis (< 200 CD4 cells/μL). Results: Among 227 newly diagnosed HIV-infected patients, 107 (47%) had late HIV diagnosis. Patients who had first positive tests for HIV at voluntary testing sites [odds ratio (OR): 0.22; 95% confidence interval (CI): 0.10-0.50], regular sexual partners at HIV diagnosis (OR: 0.30; 95% CI: 0.14-0.68), and unprotected sex in the preceding 3 months (OR: 0.16; 95% CI: 0.07-0.34) were less likely to have late HIV diagnosis. Missed opportunities for HIV testing after seeking medical attention occurred in 47 patients (20.7%) and were more common in patients with late HIV diagnosis than in those who received an earlier diagnosis (23.0% vs. 15.8%, p = 0.03). Patients with late HIV diagnosis were more likely than their counterparts to have received a diagnosis of seborrheic dermatitis (7.4% vs. 0.8%, p = 0.02) and community-acquired pneumonia (5% vs. 0%, p = 0.02), for which HIV testing was not offered by the health care providers. Conclusion: Late HIV diagnosis is not uncommon in Taiwan. Regular risk assessment and provision of routine HIV testing in medical encounters and increase of accessibility to voluntary HIV testing could facilitate earlier diagnosis of HIV infection. ? 2011 Elsevier & Formosan Medical Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79960375295&doi=10.1016%2fS0929-6646%2811%2960046-6&partnerID=40&md5=41e4335563851e06332303da4a0436cc https://scholars.lib.ntu.edu.tw/handle/123456789/535363 |
ISSN: | 0929-6646 | DOI: | 10.1016/S0929-6646(11)60046-6 | SDG/關鍵字: | adolescent; adult; article; community acquired pneumonia; delayed diagnosis; female; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; major clinical study; male; risk assessment; risk factor; seborrheic dermatitis; sexual behavior; social behavior |
顯示於: | 醫學系 |
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