Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil
ABSTRACT Objective Early, continued engagement with the HIV treatment continuum can help achieve viral suppression, though few studies have explored how risk factors for delays differ across the continuum. The objective of this study was to identify predictors of delayed diagnosis, delayed linkage t...
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ftdoajarticles:oai:doaj.org/article:bd8a844b159841bb8eeb49adf13fd925 2023-05-15T15:14:39+02:00 Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil Sarah MacCarthy Michael Hoffmann Amy Nunn Luís Augusto Vasconcelos da Silva Ines Dourado https://doaj.org/article/bd8a844b159841bb8eeb49adf13fd925 EN ES PT eng spa por Pan American Health Organization http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892016001200418&lng=en&tlng=en https://doaj.org/toc/1680-5348 1680-5348 https://doaj.org/article/bd8a844b159841bb8eeb49adf13fd925 Revista Panamericana de Salud Pública, Vol 40, Iss 6, Pp 418-426 AIDS HIV continuity of patient care diagnosis patient compliance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article ftdoajarticles 2022-12-31T12:01:09Z ABSTRACT Objective Early, continued engagement with the HIV treatment continuum can help achieve viral suppression, though few studies have explored how risk factors for delays differ across the continuum. The objective of this study was to identify predictors of delayed diagnosis, delayed linkage to care, and nonadherence to treatment in the city of Salvador, Bahia, Brazil. Methods Data were collected during 2010 in a cross-sectional study with a sample (n = 1 970) of HIV-infected individuals enrolled in care. Multiple logistic regression analyses identified sociodemographic variables, behaviors, and measures of health service quality that were associated with delayed diagnosis, delayed linkage to care, and treatment nonadherence. Results For delayed diagnosis, male gender (adjusted odds ratio (AOR), 3.02; 95% confidence interval (CI), 2.0–4.6); age 45 years and older (AOR, 1.67; 95% CI, 1.1–2.5); and provider-initiated testing (AOR, 3.00; 95% CI, 2.1–4.4) increased odds, while drug use (AOR, 0.29; 95% CI, 0.2–0.5) and receiving results in a private space (AOR, 0.37; 95% CI, 0.2–0.8) decreased odds. For delayed linkage to care, unemployment (AOR, 1.42; 95% CI, 1.07–1.9) and difficulty understanding or speaking with a health care worker (AOR, 1.61; 95% CI, 1.2–2.1) increased odds, while posttest counseling (AOR, 0.49; 95% CI, 0.3–0.7) decreased odds. For nonadherence, experiencing verbal or physical discrimination related to HIV (AOR, 1.94; 95% CI, 1.3–3.0) and feeling mistreated or not properly attended to at HIV care (AOR, 1.60; 95% CI, 1.0–2.5) increased odds, while posttest counseling (AOR, 0.34; 95% CI, 0.2–0.6) decreased odds. Conclusions More attention is needed on how policies, programs, and research can provide tailored support across the treatment continuum. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
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Directory of Open Access Journals: DOAJ Articles |
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English Spanish Portuguese |
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AIDS HIV continuity of patient care diagnosis patient compliance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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AIDS HIV continuity of patient care diagnosis patient compliance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Sarah MacCarthy Michael Hoffmann Amy Nunn Luís Augusto Vasconcelos da Silva Ines Dourado Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil |
topic_facet |
AIDS HIV continuity of patient care diagnosis patient compliance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
ABSTRACT Objective Early, continued engagement with the HIV treatment continuum can help achieve viral suppression, though few studies have explored how risk factors for delays differ across the continuum. The objective of this study was to identify predictors of delayed diagnosis, delayed linkage to care, and nonadherence to treatment in the city of Salvador, Bahia, Brazil. Methods Data were collected during 2010 in a cross-sectional study with a sample (n = 1 970) of HIV-infected individuals enrolled in care. Multiple logistic regression analyses identified sociodemographic variables, behaviors, and measures of health service quality that were associated with delayed diagnosis, delayed linkage to care, and treatment nonadherence. Results For delayed diagnosis, male gender (adjusted odds ratio (AOR), 3.02; 95% confidence interval (CI), 2.0–4.6); age 45 years and older (AOR, 1.67; 95% CI, 1.1–2.5); and provider-initiated testing (AOR, 3.00; 95% CI, 2.1–4.4) increased odds, while drug use (AOR, 0.29; 95% CI, 0.2–0.5) and receiving results in a private space (AOR, 0.37; 95% CI, 0.2–0.8) decreased odds. For delayed linkage to care, unemployment (AOR, 1.42; 95% CI, 1.07–1.9) and difficulty understanding or speaking with a health care worker (AOR, 1.61; 95% CI, 1.2–2.1) increased odds, while posttest counseling (AOR, 0.49; 95% CI, 0.3–0.7) decreased odds. For nonadherence, experiencing verbal or physical discrimination related to HIV (AOR, 1.94; 95% CI, 1.3–3.0) and feeling mistreated or not properly attended to at HIV care (AOR, 1.60; 95% CI, 1.0–2.5) increased odds, while posttest counseling (AOR, 0.34; 95% CI, 0.2–0.6) decreased odds. Conclusions More attention is needed on how policies, programs, and research can provide tailored support across the treatment continuum. |
format |
Article in Journal/Newspaper |
author |
Sarah MacCarthy Michael Hoffmann Amy Nunn Luís Augusto Vasconcelos da Silva Ines Dourado |
author_facet |
Sarah MacCarthy Michael Hoffmann Amy Nunn Luís Augusto Vasconcelos da Silva Ines Dourado |
author_sort |
Sarah MacCarthy |
title |
Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil |
title_short |
Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil |
title_full |
Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil |
title_fullStr |
Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil |
title_full_unstemmed |
Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil |
title_sort |
barriers to hiv testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of brazil |
publisher |
Pan American Health Organization |
url |
https://doaj.org/article/bd8a844b159841bb8eeb49adf13fd925 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 40, Iss 6, Pp 418-426 |
op_relation |
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892016001200418&lng=en&tlng=en https://doaj.org/toc/1680-5348 1680-5348 https://doaj.org/article/bd8a844b159841bb8eeb49adf13fd925 |
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1766345079682760704 |