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Predictors of Late Presentation for HIV Diagnosis: A Literature Review and Suggested Way Forward

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Abstract

Early commencement of antiretroviral treatment can be beneficial and economical in the long run. Despite global advances in access to care, a significant proportion of adults presenting at HIV/AIDS care facilities present with advanced HIV disease. Understanding factors associated with late presentation for HIV/AIDS services is critical to the development of effective programs and treatment strategies. Literature on factors associated with late presentation for an HIV diagnosis is reviewed. Highlighted is the current emphasis on socio-demographic factors, the limited exploration of psychosocial correlates, and inconsistencies in the definition of late presentation that make it difficult to compare findings across different studies. Perspectives based on experiences from resource limited settings are underreported. Greater exploration of psychosocial predictors of late HIV diagnosis is advocated for, to guide future intervention research and to inform public policy and practice targeted at ‘difficult to reach’ populations.

Resumen

La iniciación del tratamiento antirretroviral (TAR) precoz puede ser beneficiosa y económica a largo plazo. A pesar de los avances mundiales en el acceso a la atención y tratamiento de VIH/SIDA, una proporción significativa de adultos que acuden a los establecimientos de atención del VIH / SIDA se presentan con la enfermedad avanzada. El entender los factores asociados con la presentación tardía del VIH / SIDA es fundamental para el desarrollo de programas y estrategias eficaces de tratamiento. En este articulo, presentamos una revisión de la literatura sobre los factores asociados con la presentación tardía del diagnóstico de VIH. Observamos que en la literatura hay un énfasis en estudiar los factores socio-demográficos, a la vez que hay una exploración limitada de correlaciones psicosociales, y también observamos inconsistencias en la definición de “presentación tarde de VIH” que hacen difícil comparar resultados entre los diferentes estudios. Tambien presentamos perspectivas sobre las experiencias de entornos de recursos limitados. Recomendamos una mayor exploración de factores psicosociales asociados con presentación tarde de VIH para poder guiar la futura intervención y formulación de políticas públicas y prácticas dirigidas a poblaciones que son difíciles de alcanzar.

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Mukolo, A., Villegas, R., Aliyu, M. et al. Predictors of Late Presentation for HIV Diagnosis: A Literature Review and Suggested Way Forward. AIDS Behav 17, 5–30 (2013). https://doi.org/10.1007/s10461-011-0097-6

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