Delayed presentation and late testing for HIV: demographic and behavioral risk factors in a multicenter study in Italy |
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Authors: | Girardi Enrico,Aloisi Maria Stella,Arici Claudio,Pezzotti Patrizio,Serraino Diego,Balzano Roberta,Vigevani Gianmarco,Alberici Francesco,Ursitti Maria,D'Alessandro Margherita,d'Arminio Monforte Antonella,Ippolito Giuseppe ICoNA Behavioural Epidemiology Study Group |
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Affiliation: | Dipartimento di Epidemiologia, INMI Lazzaro Spallanzani, Roma, Italy. girardi@inmi.it |
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Abstract: | Ensuring timely access to care for persons with HIV is an important public health goal. To identify factors associated with delayed presentation to medical care after testing HIV-positive or with late HIV testing, we studied 968 patients at their first HIV care visit, enrolled in a multicenter study in Italy from 1997-2000. Patients completed a questionnaire on HIV-testing history, sexual behavior, and drug use behavior. Delayed presenters were patients with >6 months between their first HIV-positive test and presentation for HIV care; late testers were patients with CD4 count < 200 /mm or clinically defined AIDS at their first HIV-positive test. Among the study patients, 255 (26.3%) were delayed presenters, and 280 (28.9%) were late testers. In multinomial logistic regression analysis, injection drug use significantly increased (odds ratio [OR]= 5.04) the probability of delayed presentation but reduced (OR = 0.55) the chance of late testing. A previous HIV-negative test was associated with a reduced risk of both delayed presentation (OR = 0.39) and late testing (OR = 0.36). Unemployment was positively associated with delayed presentation and increasing age with late testing, whereas HIV counseling at the time of first positive HIV test strongly (OR = 0.42) reduced the odds of delayed presentation. Interventions aimed at promoting timely access to care of HIV-infected persons should consider differentiated programs for delayed presentation and late testing. |
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