Educational Gradient in HIV Diagnosis Delay, Mortality, Antiretroviral Treatment Initiation and Response in a Country with Universal Health Care

Sobrino-Vegas, Paz; Rodríguez-Urrego, Johana; Berenguer, Juan; Caro-Murillo, Ana María; Blanco, José Ramón; Viciana, Pompeyo; Moreno, Santiago; Bernardino, José I.; Amo, Julia del; CoRIS,

doi:10.3851/imp1939

Cited by 44 publications

(40 citation statements)

References 24 publications

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“…Less than 1 in 10 were initiated on ART within a week of diagnosis. The time to ART was lower than reported elsewhere globally and similar to a study from Malawi (for the year 2011) [5–11]. However, this has to be interpreted with caution as the eligibility criteria might vary based on the study site and period.…”

Section: Discussionsupporting

confidence: 44%

“…Studies globally have reported a long time to enter into care and/or initiate ART after HIV diagnosis [5–11]. The enrolment and ART initiation delay (Figure 1) can be due to underlying factors like client readiness/refusal, physical disability and physician concerns to defer ART initiation during the treatment of co-morbidities especially anti-TB treatment [6,8,10].…”

Section: Introductionmentioning

confidence: 99%

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Time to anti-retroviral therapy among people living with HIV enrolled into care in Myanmar: how prepared are we for ‘test and treat’?

Linn

Shewade

Htet³

et al. 2018

Global Health Action

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Background: Among people living with HIV (PLHIV) enrolled into care, time to anti-retroviral therapy (ART) has not been studied in Myanmar. To inform progress, we conducted this operational research among treatment-naive PLHIV (≥18 years) enrolled during a period of three years (2014–2016) at Pyin Oo Lwin, Myanmar. Objectives: To determine (i) the time from HIV diagnosis to ART initiation (time to ART) and associated factors and (ii) the association between time to ART and attrition (loss to follow-up and death) from ART care. Methods: This was a retrospective cohort study involving a record review of secondary programme data. The PLHIV were followed up to 5 December 2017 for ART initiation and up to 31 March 2018 (date of censoring) for attrition during ART. Results: Of 543 enrolled, 373 (69%) were found to be eligible and initiated on ART. Of 373, 245 (67%) were initiated within 6 weeks of enrolment. The median enrolment delay (from diagnosis) was 4 (IQR: 1, 14) days and median ART initiation delay (from ART eligibility) was 20 (IQR: 13, 36) days. The median time to ART (excluding the time interval in pre-ART care) was 29 (IQR: 18, 55) days and was significantly long in those with prevalent TB and CD4 count ≥ 500/mm3 at enrolment. Among 373, the annual incidence density of attrition was 12.8% (0.95 CI: 10.2, 15.7). Attrition was common in first 100 days. Time to ART (after excluding time interval in pre-ART care) was not significantly associated with attrition. Conclusion: The programme appears to be on track to initiate ART as soon as possible in a ‘test and treat’ scenario (implemented since September 2017) subject to interventions to reduce ART initiation delay.

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Section: Discussionsupporting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Time to anti-retroviral therapy among people living with HIV enrolled into care in Myanmar: how prepared are we for ‘test and treat’?

Linn

Shewade

Htet³

et al. 2018

Global Health Action

View full text Add to dashboard Cite

show abstract

“…This association has also been found in other studies [6,7,14,19,21] in addition to a lower level of education (a surrogate marker of socioeconomic status) [24,25]. In a study in London, a sub-Saharan origin was associated with a two-fold higher risk of diagnosis with advanced disease than the natives after adjusting for gender and risk group [5].…”

Section: Mortalitysupporting

confidence: 61%

Predictors of Delayed Diagnosis and Evolution in Sub-Saharan Immigrants with HIV Infection in a Hospital in Madrid (2004–2013)

Blandino¹,

Jv²,

García-Arata³

et al. 2017

Journal of AIDS and HIV Infections

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“…In women, liver-related SMR was 38 times higher than for women of the general population of the same age. These differences may be explained by the relative low liver-related death in women from the general population [35], together with the special characteristics of the HIV positive women; a higher prevalence of co-morbidities (29.5% of women in this study were current or former injecting drug users and 40.2% were co-infected with HCV) and their lower socio-economic level [36].…”

Section: Discussionmentioning

confidence: 96%

All-cause and liver-related mortality in HIV positive subjects compared to the general population: Differences by HCV co-infection

Hernando

Cachafeiro

Lewden

et al. 2012

Journal of Hepatology

Self Cite

107

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Educational Gradient in HIV Diagnosis Delay, Mortality, Antiretroviral Treatment Initiation and Response in a Country with Universal Health Care

Cited by 44 publications

References 24 publications

Time to anti-retroviral therapy among people living with HIV enrolled into care in Myanmar: how prepared are we for ‘test and treat’?

Time to anti-retroviral therapy among people living with HIV enrolled into care in Myanmar: how prepared are we for ‘test and treat’?

Predictors of Delayed Diagnosis and Evolution in Sub-Saharan Immigrants with HIV Infection in a Hospital in Madrid (2004–2013)

All-cause and liver-related mortality in HIV positive subjects compared to the general population: Differences by HCV co-infection

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