Factors associated with delayed and late ART initiation among people living with HIV in BC : results from the engage study
We examined correlates of late and delayed initiation of antiretroviral therapy (ART) in British Columbia, Canada. From December 2013 to December 2015 we recruited treatment-naïve people living with HIV who initiated ART within the previous year. 'Late initiation' was defined as CD4 cell count ≤500 cells/µL at ART initiation and 'delayed initiation' as ≥1 year between HIV diagnosis and initiation. Multivariable logistic regression assessed independent correlates of late and delayed initiation. Of 87 participants, 44 (51%) initiated late and 22 (26%) delayed initiation. Delayed initiation was positively associated with older age (adjusted odds ratio [AOR]: 1.06 per year, 95% confidence interval [95% CI]: 1.01-1.12) and inversely associated with wanting to start ART at diagnosis (AOR: 0.06, 95% CI: 0.02-0.21). Variables associated with late initiation were older age (AOR: 1.09 per year, 95% CI: 1.03-1.15) and medical reason(s) for initiation (AOR: 5.00, 95% CI: 1.41-17.86). Late initiation was less likely among those with greater perceived ART efficacy (AOR 0.94, 95% CI: 0.90-0.98) and history of incarceration (AOR: 0.12, 95% CI: 0.03-0.56). Disparities in timing of initiation were observed for age, perceived ART efficacy, and history of incarceration. Enhanced health services that address these factors may facilitate earlier treatment initiation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
AIDS care - 31(2019), 7 vom: 23. Juli, Seite 885-892 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kesselring, Sarah [VerfasserIn] |
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| Links: |
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| Themen: |
ART |
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| Anmerkungen: |
Date Completed 04.03.2020 Date Revised 04.03.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/09540121.2018.1549722 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM290977649 |
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| 245 | 1 | 0 | |a Factors associated with delayed and late ART initiation among people living with HIV in BC |b results from the engage study |
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| 520 | |a We examined correlates of late and delayed initiation of antiretroviral therapy (ART) in British Columbia, Canada. From December 2013 to December 2015 we recruited treatment-naïve people living with HIV who initiated ART within the previous year. 'Late initiation' was defined as CD4 cell count ≤500 cells/µL at ART initiation and 'delayed initiation' as ≥1 year between HIV diagnosis and initiation. Multivariable logistic regression assessed independent correlates of late and delayed initiation. Of 87 participants, 44 (51%) initiated late and 22 (26%) delayed initiation. Delayed initiation was positively associated with older age (adjusted odds ratio [AOR]: 1.06 per year, 95% confidence interval [95% CI]: 1.01-1.12) and inversely associated with wanting to start ART at diagnosis (AOR: 0.06, 95% CI: 0.02-0.21). Variables associated with late initiation were older age (AOR: 1.09 per year, 95% CI: 1.03-1.15) and medical reason(s) for initiation (AOR: 5.00, 95% CI: 1.41-17.86). Late initiation was less likely among those with greater perceived ART efficacy (AOR 0.94, 95% CI: 0.90-0.98) and history of incarceration (AOR: 0.12, 95% CI: 0.03-0.56). Disparities in timing of initiation were observed for age, perceived ART efficacy, and history of incarceration. Enhanced health services that address these factors may facilitate earlier treatment initiation | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Osborne, Charles |e verfasserin |4 aut | |
| 700 | 1 | |a Bever, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Salters, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Cui, Zishan |e verfasserin |4 aut | |
| 700 | 1 | |a Chia, Jason |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, David M |e verfasserin |4 aut | |
| 700 | 1 | |a Parashar, Surita |e verfasserin |4 aut | |
| 700 | 1 | |a Kaida, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a Samji, Hasina |e verfasserin |4 aut | |
| 700 | 1 | |a Duddy, Janice |e verfasserin |4 aut | |
| 700 | 1 | |a Gabler, Karyn |e verfasserin |4 aut | |
| 700 | 1 | |a Howard, Terry |e verfasserin |4 aut | |
| 700 | 1 | |a Nash, Denis |e verfasserin |4 aut | |
| 700 | 1 | |a McCandless, Lawrence C |e verfasserin |4 aut | |
| 700 | 1 | |a Patterson, Thomas L |e verfasserin |4 aut | |
| 700 | 1 | |a Corneil, Trevor |e verfasserin |4 aut | |
| 700 | 1 | |a Montaner, Julio S G |e verfasserin |4 aut | |
| 700 | 1 | |a Hogg, Robert S |e verfasserin |4 aut | |
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