HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil

Abstract

OBJECTIVE To analyze the clinical and laboratory characteristics of HIV-infected individuals upon admission to a reference health care center.METHODS This cross-sectional study was conducted between 1999 and 2010 on 527 individuals with confirmed serological diagnosis of HIV infection who were enrolled in an outpatient health care service in Santarém, PA, Northern Brazil. Data were collected from medical records and included the reason for HIV testing, clinical status, and count of peripheral CD4+ T lymphocytes upon enrollment. The data were divided into three groups, according to the patient’s year of admission – P1 (1999-2002), P2 (2003-2006), and P3 (2007-2010) – for comparative analysis of the variables of interest.RESULTS In the study group, 62.0% of the patients were assigned to the P3 group. The reason for undergoing HIV testing differed between genders. In the male population, most tests were conducted because of the presence of symptoms suggesting infection. Among women, tests were the result of knowledge of the partner’s seropositive status in groups P1 and P2. Higher proportion of women undergoing testing because of symptoms of HIV/AIDS infection abolished the difference between genders in the most recent period. A higher percentage of patients enrolling at a more advanced stage of the disease was observed in P3.CONCLUSIONS Despite the increased awareness of the number of HIV/AIDS cases, these patients have identified their serological status late and were admitted to health care units with active disease. The HIV/AIDS epidemic in Pará presents specificities in its progression that indicate the complex characteristics of the epidemic in the Northern region of Brazil and across the country.

HIV Care Continuum from diagnosis in a Counseling and Testing Center

“…A study carried out in a Brazilian reference center showed that, upon admission to the service, more than half (52%) of HIV positive users had a CD4 + T lymphocyte count below 200 cells/µL and the presence of at least one AIDS-defining disease (7) .…”

“…One study lists hegemonic masculinity as a contributing factor for heterosexual men to present themselves as invulnerable, resulting in irregular condom use and not seeking HIV testing (6) . Besides, the presence of infection symptoms was the most cited reason for HIV testing among the male population in a Brazilian state, characterizing a late diagnosis (7) . In southern Africa, a study has shown that men are more likely to seek treatment later (CD4+ T L ≤ 200 cells/µL) than women, compared to early search (CD4+ T L ≥ 500 cells/ µL) (8) .…”

“…Studies show that individuals are making a late diagnosis of HIV infection when admitted to specialized health services (7,(10)(11) without, however, identifying the location of the diagnostic exam. Among the suggested interventions, there is the expansion of the opening of CTCs, with RT enforcement to improve access to diagnosis (7) . Considering the exposed data and the few studies that analyze the care cascade from CTC, especially related to sex, we question:…”

Analysis of deaths due to acquired immunodeficiency syndrome

“…These actions make it possible to improve the quality of life of people with HIV/AIDS, reduce the mortality associated with AIDS and the transmission of the disease. It is also necessary to identify the groups most vulnerable to HIV in terms of acquisition of infection and risk of illness (17) .…”

Fatores associados ao não uso de preservativo e prevalência de HIV, hepatites virais B e C e sífilis: estudo transversal em comunidades rurais de Ouro Preto, Minas Gerais, entre 2014 e 2016*

“…2,3 However, those studies do not reflect local and regional particularities of the epidemics, especially in relation to cultural and behavioral aspects. [6][7][8] The highest number of HIV/AIDs cases reported on SINAN in the last ten years in Ouro Preto, Minas Gerais, occurred in 2016: 19 cases among 74,000 inhab., or 2.6 cases per 10,000 inhab. This fact may be related to the creation in Ouro Preto of the Communicable and Parasitic Diseases Outpatients Department at the Federal University of Ouro Preto in 2010, the Specialized HIV/AIDS and Viral Hepatitis Care Service in 2014, and the Antiretroviral Medication Dispensing Unit in 2016.…”