Mixed method approach for determining factors associated with late presentation to HIV/AIDS care in southern India.
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The qualitative summary showed that the perceived HIV stigma, inadequate health education, lack of awareness on available government services, psychological problems, alcohol use, asymptomatic conditions, and financial problems are major barriers to access care early for the late presenters.Abstract:
Background: Early diagnosis and treatment of human Immunodeficiency virus (HIV) is not only beneficial for the people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLHA) but for the public and society as well. The study was aimed to identify the factors associated with late presentation to HIV/AIDS care. Materials and Methods: A facility-based unmatched case-control (1:1) study along with in-depth qualitative assessment was conducted at an ART Plus center at a district hospital, Udupi, southern India. A sample of 320 HIV patients (160 cases and 160 controls) was selected randomly between February and July 2014. Information regarding the patients were collected using an interviewer-administered semi-structured questionnaire. The qualitative component was assessed by in-depth interviews of 4 health professionals and 12 HIV-positive patients who were late for HIV care. The quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS) version 15.0. The technique of thematic analysis was adopted for the analysis of qualitative data. Results: HIV-positive individuals who lived with families [odds ratio (OR) = 5.11], the patients having non-AIDS comorbidities [OR= 2.19, 95% confidence interval (CI): 1.09-4.40], the patients who perceived fear of losing family [OR = 5.00, 95% CI: 2.17-11.49], the patients who perceived fear that their status will be ruined in the community [OR= 2.00, 95% CI: 1.01-3.97], the patients who perceived fear of side effects of ART medications [OR = 4.3, 95% CI: 2.65-11.33], the patients who perceived fear of losing confidentiality [OR = 4.94, 95% CI: 2.54-9.59], the patients those who lack information available on government services [OR = 4.12, 95% CI: 2.127-8.005], and the patients who consumed alcohol [OR= 3.52, 95% CI: 1.83-6.77] were found to be independently associated with the late presentation to HIV/AIDS care after adjusting for all known confounders in a multivariable analysis. The qualitative summary showed that the perceived HIV stigma, inadequate health education, lack of awareness on available government services, psychological problems, alcohol use, asymptomatic conditions, and financial problems are major barriers to access care early for the late presenters. Conclusion: The identified factors can be utilized for the formulation of policies and interventions by promoting early diagnoses and addressing special concerns such as stigma, disclosure, health education, and awareness.read more
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Late presentation of HIV positive adults and its predictors to HIV/AIDS care in Ethiopia: a systematic review and meta-analysis
TL;DR: Frequent alcohol use, high fear of stigma, chronic illness, and the presence of symptoms at the time of HIV diagnosis were associated with high odds of late presentation to HIV/AIDS care in Ethiopia.
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Late Presentation of HIV Infection in the Netherlands: Reasons for Late Diagnoses and Impact on Vocational Functioning.
S.E.M. van Opstal,S.E.M. van Opstal,J. S. van der Zwan,M.N. Wagener,Sabrina K. Been,Harald S. Miedema,Pepijn D D M Roelofs,E. C. M. van Gorp +7 more
TL;DR: The experiences of 34 late-presenters were explored through in-depth semi-structured interviews and a variety of reasons for late diagnoses emerged, which led to a division into four groups, characterized by two dimensions.
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Correlates of Late Presentation to HIV care in a South Indian Cohort.
TL;DR: There is a need to strengthen the HIV care cascade by linking PLWHA to cART immediately after diagnosis and linking positive partners of people living with HIV/AIDS (PLWHA).
Journal ArticleDOI
Perceptions of alcohol use in the context of HIV treatment: a qualitative study.
Munyaradzi Madhombiro,Bazondlile Marimbe-Dube,Michelle Dube,Malinda Kaiyo-Utete,Angeline Paradzai,Dixon Chibanda,Simbarashe Rusakaniko,Alberta S.J. van der Watt,Soraya Seedat +8 more
TL;DR: People living with HIV have adequate knowledge of the effects of alcohol use in the context of HIV treatment, and Stigma and the time taken to engage in an alcohol use intervention appeared to be the main impediments to uptake.
Late presentation of HIV infection in the Netherlands
S.E.M. van Opstal,J. S. van der Zwan,M.N. Wagener,Sabrina K. Been,Harald S. Miedema,Pepijn D D M Roelofs,E. C. M. van Gorp +6 more
TL;DR: In this article, a qualitative study explored the experiences of 34 late-presenters through in-depth semi-structured interviews and found that about 50% of all people living with HIV are diagnosed late after infection has occurred.
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