Factors responsible for incomplete linkage to care after <scp>HIV</scp> diagnosis: preliminary results from the Test and Keep in Care (<scp>TAK</scp>) project

Ankiersztejn-Bartczak, Magdalena; Firląg-Burkacka, Ewa; Czeszko-Paprocka, Hanna; Kubicka, Joanna; Cybula, Aneta; Horban, Andrzéj

doi:10.1111/hiv.12175

Cited by 17 publications

(20 citation statements)

References 32 publications

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“…It should be noted that, in Poland, HIV testing services are largely provided in community‐based voluntary counselling and testing (VCT) facilities (free of charge) and through parallel testing via private laboratories (costing 10–20 euro/test). VCT facilities provide anonymous testing that is available to all adults, including migrants, regardless of medical insurance; however, it has been shown that linkage to care may be as low as 62.1%, with barriers to care entry being bi‐ or heterosexual orientation, lower level of education, young age and inconsistent condom use . This implies that the fear of stigma, discrimination and disclosure of sexual orientation may still play a role in delayed testing and therefore care entry.…”

Section: Discussionmentioning

confidence: 99%

Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

et al. 2019

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Introduction Delay in HIV diagnosis and consequently late care entry with low CD4 counts remain a major challenge for the control of the HIV/AIDS epidemic. The aim of this study was to analyse the evolution of characteristics of the HIV epidemic in Poland. Methods Cross‐sectional data were collected for 3972 HIV‐infected patients followed up in 14 of 17 Polish HIV treatment centres in the years 2000–2015. Clinical data were analysed and factors associated with late presentation (baseline CD4 count < 350 cells/μL or history of AIDS‐defining illness) and advanced HIV disease (baseline CD4 count < 200 cells/μL or history of AIDS) were identified. Results The majority (57.6%) of patients entered care late, while 35.6% presented with advanced HIV disease. The odds of being linked to care late or with advanced HIV disease increased consistently across age categories, increasing from 2.55 [95% confidence interval (CI) 1.46–4.47] for late presentation and 3.13 (95% CI 1.49–6.58) for advanced disease for the 21–30‐year‐old category to 5.2 (95% CI 1.94–14.04) and 8.15 (95% CI 2.88–23.01), respectively, for individuals > 60 years of age. Increased risks of late entry and advanced HIV disease were also observed for injecting drug users [adjusted odds ratio (aOR) 1.74 (95% CI 1.16–2.60) and 1.55 (95% CI 1.05–2.30), respectively], with lower aOR associated with the men who have sex with men transmission route [aOR 0.3 (95% CI 0.31–0.59) and 0.39 (95% CI 0.29–0.53), respectively]. The frequencies of cases in which patients were linked to care late and with advanced HIV disease decreased over time from 67.6% (2000) to 53.5% (2015) (P < 0.0001) and from 43.5% (2000) to 28.4% (2015) (P = 0.001), respectively. Conclusions Despite improvements over time, most patients diagnosed with HIV infection entered care late, with a third presenting with advanced HIV disease. Late care entry remains common among people who inject drugs and heterosexual groups.

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Section: Discussionmentioning

confidence: 99%

Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

et al. 2019

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“…This happened despite universal adoption of proactive linkage procedures by Polish VCT centers. 13 Such high number of persons LTC necessitates rapid improvement so that neither funds nor lives are lost despite timely diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Making HIV clinic appointments for clients with positive HIV results at testing sites can improve referral rates

Szetela¹,

Łapiński²,

Gąsiorowski³

et al. 2018

Adv Clin Exp Med

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Background. The percentage of people living with undiagnosed HIV infection remains very high in Poland and exceeds 50%-one of the highest rates in Europe. At the same time, the number of HIV tests performed by medical doctors per 1,000 inhabitants is the lowest in Europe. Thus, every effort should be made to keep diagnosed patients in care. However, a number of patients are lost to care (LTC), with the percentage depending on the testing modality used (voluntary counseling and testing sites-VCTs, private laboratories, medical clinics, clubs) and communication skills of persons giving the results. Until now, there was only 1 prospective study in Poland that looked into the problem of continuum of care. Objectives. The objective of the study was to assess VCT clients' willingness to accept help with making the first appointment at a local HIV clinic after receiving positive results and the percentage of patients getting into care at the clinic after referral. Material and methods. Referral efficacy analysis between 2010 and 2014 was a joint venture between VCT site and the largest HIV clinic in Wrocław. Every patient diagnosed with HIV infection was offered personal help with making the first appointment at the HIV clinic. Later, it was assessed whether the first visit actually took place. Results. All the patients who collected their positive results came for their first visit at the HIV clinic with a referral rate reaching 100%, falling to 97. 1% only in 2013. Most visits took place during 1-2 weeks. Conclusions. Patients were willing to use counselors' help with making appointments at the HIV clinic, which in turn increased referral rates and numbers of patients retained in care.

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“…In accordance with the newest guidelines of the PTN AIDS and EACS, each patient with the confirmed HIV infection and the readiness to take up treatment should begin it without undue delay [24,26]. The percentage of the persons receiving effective therapy and persons with its full effectiveness in Poland is high, yet the percentage of the persons who seek medical care after the HIV infection diagnosis remains unsatisfying [27,28].…”

Section: Discussionmentioning

confidence: 99%

Rationales for indicator condition-based HIV testing data from the Hospital for Infectious Diseases in Warsaw – one-year observation

Pyziak-Kowalska¹,

Kowalska²,

Horban³

2017

HIV & AIDS Review

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Factors responsible for incomplete linkage to care after HIV diagnosis: preliminary results from the Test and Keep in Care (TAK) project

Cited by 17 publications

References 32 publications

Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

Making HIV clinic appointments for clients with positive HIV results at testing sites can improve referral rates

Rationales for indicator condition-based HIV testing data from the Hospital for Infectious Diseases in Warsaw – one-year observation

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