Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil / Obstáculos a las pruebas de detección del VIH, la vin¬culación con la atención y la observancia terapéutica: Estudio transversal de un importante centro urbano de Brasil
Rev Panam Salud Publica
; 40(6), dic. 2016
Article
em En
| PAHOIRIS
| ID: phr-33661
Biblioteca responsável:
US1.1
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.
Texto completo:
1
Coleções:
04-international_org
Base de dados:
PAHOIRIS
Assunto principal:
Brasil
/
Síndrome da Imunodeficiência Adquirida
/
HIV
/
Cooperação do Paciente
/
Continuidade da Assistência ao Paciente
/
Diagnóstico
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article