Prevalence and Factors Associated With Late Diagnosis of the Hiv Infection in a Municipality of São Paulo

Abstract

Objective: to identify the prevalence and factors associated with late diagnosis of the infection by the Human Immunodeficiency Virus (HIV), in a municipality of São Paulo. Method: an epidemiological, analytical and retrospective study that analyzed the HIV and AIDS cases notified by the health services in the period from 2015 to 2017 using data from the notifications of the Information System for Notifiable Diseases (SINAN Net) corresponding to the users recently diagnosed with HIV/AIDS infection in the municipality of Ribeirão Preto/SP, Brazil. Data collection was in May 2018. The chi-square test was performed, as well as binary logistic regression, where the dependent variable was the AIDS criterion at the moment of notifying infection by HIV. A p-value<0.05 was considered for the association between the variables studied in relation to late diagnosis. Results: of the 829 (100%) new HIV cases, 290 (35.0%) were diagnosed in the condition of AIDS. Most of the population was male and aged between 15 and 34 years old. Oral candidiasis and weight loss greater than 10% were the main symptoms associated with AIDS. It was observed that people with lower schooling levels and older were more prone to late diagnoses. Conclusion: it is necessary to devise strategies that favor timely diagnosis in the municipality under study, particularly among the individuals aged over 45 years old and with lower schooling levels.

Clusters da heterogeneidade da coinfecção tuberculose-HIV no Brasil: um estudo geoespacial

“…Late diagnosis is linked to individual issues, such as lack of resources for transportation, social status, or distance between the home and the facility; and/or collective issues, such as stigma about HIV, fear of disclosing the diagnosis, lack of a support network, failure to articulate the network, and political and legal obstacles that weaken access to care 39 , 40 . This demonstrates the need for policies and actions capable of reaching all these singularities.…”

“…O diagnóstico tardio atrela-se a questões individuais, como falta de recursos para transporte, status social ou distância entre o domicílio e o estabelecimento; e/ou a questões coletivas, a exemplo do estigma acerca do HIV, medo da revelação do diagnóstico, ausência de rede de apoio, falha na articulação da rede e obstáculos políticos e legais que fragilizam o acesso ao cuidado 39 , 40 . Isso demonstra a necessidade de políticas e ações capazes de alcançar todas essas singularidades.…”

Early diagnosis of HIV/aids infection: concept analysis

“…Nowadays, there is an increase in the number of individuals infected and living with HIV and able to have a good quality of life because, with the technological advancement and growth of the pharmaceutical industry, specific drugs have been developed to contain viral replication, with the use of antiretroviral therapy (ART) ( 22 ) . Early diagnosis is essential for the best prognosis for those who live virus ( 29 ) .…”

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“…Haja visto que, o diagnóstico precoce é essencial para o melhor prognóstico de quem vive com o vírus 47 . A PHIV, quando utiliza de forma adequada as medicações, consegue estabelecer estratégias para melhorar e garantir suas atividades laborais, convívio familiar e ter qualidade de vida 48 .…”

“…É de fundamental importância insistir na identificação precoce 47 , no apoio aos pacientes diagnosticados com HIV 12 , bem como no preenchimento adequado das fichas de notificação 46 . Para assim, estruturar um cuidado integralizado, individualizado e baseado nas evidências mais atualizadas, buscando, assim, dirimir a presença dos CID B20 e B24 como causa básica nas declarações de óbito.…”