Determinants of Late HIV Diagnosis and Advanced HIV Disease Among People Living with HIV in Tanzania.

IF 1.5 Q4 INFECTIOUS DISEASES
HIV AIDS-Research and Palliative Care Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI:10.2147/HIV.S473291
Anderson Bendera, Deogratias Mugisha Baryomuntebe, Nwanna Uchechukwu Kevin, Miisa Nanyingi, Patience Bemanya Kinengyere, Salaam Mujeeb, Esther Jachi Sulle
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引用次数: 0

Abstract

Background: About half of people infected with Human Immunodeficiency Virus (HIV) often present late for care, resulting in higher healthcare costs, undesired treatment outcomes, and ongoing HIV transmission. This study aimed to assess the prevalence and determinants of late HIV diagnosis and advanced HIV disease (AHD) in Tanzania.

Methods: Data were obtained from the 2016-17 Tanzania HIV impact survey. We included 677 newly diagnosed people living with HIV. Late HIV diagnosis and AHD were defined as having a CD4 cell count below 350 cells/µL or 200 cells/µL at diagnosis, respectively. Bivariate and multivariable logistic regression models were fitted to identify the determinants of late HIV diagnosis or AHD.

Results: The mean age of the participants was 37.8 years (SD, 12.4). About two-thirds were women (62.6%). The prevalence of late HIV diagnosis was 42.4%, whereas the prevalence of AHD was 17.7%. Factors associated with late HIV diagnosis included age 31-40 years (adjusted odds ratio [aOR] = 1.72, 95% confidence interval [CI]: 1.14-2.60), age ≥41 years (aOR = 1.79, 95% CI: 1.16-2.76), male sex (aOR = 1.88, 95% CI: 1.29-2.73), and active syphilis infection (aOR=2.63, 95% CI: 1.20-5.76). Factors associated with AHD were age 31-40 years (aOR = 2.12, 95% CI: 1.18-3.81), age ≥41 years (aOR = 2.42, 95% CI: 1.32-4.41), male sex (aOR = 1.77, 95% CI: 1.09-2.87), formal education (aOR = 0.49, 95% CI: 0.30-0.81) and active syphilis infection (aOR = 2.49, 95% CI: 1.07-5.77).

Conclusion: Late HIV diagnosis and AHD are prevalent among newly diagnosed people living with HIV in Tanzania. Specific subgroups are more likely to present late for HIV care, including middle-aged and older adults, men, illiterate individuals, and those with active syphilis and HIV co-infection. Therefore, we recommend expanding HIV testing services and implementing targeted interventions to improve early access and enrollment in HIV care.

坦桑尼亚艾滋病毒感染者中艾滋病毒晚期诊断和晚期艾滋病毒疾病的决定因素。
背景:约有一半的人类免疫缺陷病毒(HIV)感染者通常会很晚才接受治疗,从而导致医疗费用增加、治疗效果不理想以及 HIV 持续传播。本研究旨在评估坦桑尼亚艾滋病毒晚期诊断和晚期艾滋病毒疾病(AHD)的发生率和决定因素:数据来自 2016-17 年坦桑尼亚 HIV 影响调查。我们纳入了 677 名新确诊的 HIV 感染者。HIV晚期诊断和AHD分别定义为诊断时CD4细胞计数低于350个细胞/μL或200个细胞/μL。我们建立了双变量和多变量逻辑回归模型,以确定晚期HIV诊断或AHD的决定因素:参与者的平均年龄为 37.8 岁(SD,12.4)。约三分之二为女性(62.6%)。艾滋病病毒晚期诊断率为 42.4%,而 AHD 感染率为 17.7%。与艾滋病晚期诊断相关的因素包括:31-40 岁(调整后的几率比 [aOR] = 1.72,95% 置信区间 [CI]:1.14-2.60)、年龄≥41 岁(aOR = 1.79,95% CI:1.16-2.76)、男性(aOR = 1.88,95% CI:1.29-2.73)和活动性梅毒感染(aOR = 2.63,95% CI:1.20-5.76)。与AHD相关的因素有:31-40岁(aOR=2.12,95% CI:1.18-3.81)、年龄≥41岁(aOR=2.42,95% CI:1.32-4.41)、男性(aOR=1.77,95% CI:1.09-2.87)、正规教育(aOR=0.49,95% CI:0.30-0.81)和活动性梅毒感染(aOR=2.49,95% CI:1.07-5.77):结论:在坦桑尼亚,新确诊的艾滋病病毒感染者中普遍存在艾滋病病毒晚期诊断和AHD。特定的亚群体更有可能延迟接受 HIV 治疗,包括中老年人、男性、文盲以及梅毒和 HIV 合并感染者。因此,我们建议扩大艾滋病毒检测服务并实施有针对性的干预措施,以改善艾滋病毒护理的早期获取和登记。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
6.70%
发文量
61
审稿时长
16 weeks
期刊介绍: About Dove Medical Press Dove Medical Press Ltd is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC. We specialize in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine. Dove Medical Press was founded in 2003 with the objective of combining the highest editorial standards with the ''best of breed'' new publishing technologies. We have offices in Manchester and London in the United Kingdom, representatives in Princeton, New Jersey in the United States, and our editorial offices are in Auckland, New Zealand. Dr Scott Fraser is our Medical Director based in the UK. He has been in full time clinical practice for over 20 years as well as having an active research interest.
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