Skip to main content

Advertisement

SpringerLink
Log in

Factors Associated with a Delay in Seeking HIV/AIDS Treatment in São Paulo, Brazil

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

This quantitative cross-sectional study of HIV/AIDS patients (N = 1,520) in São Paulo evaluated factors associated with a delay in seeking care. Analysis included Chi square tests and multiple logistic regression. Care was sought at the AIDS stage in 56.7 % (861) of patients, and 48.2 % (732) had a CD4 count ≤350 cells/mm3; 9 % (136) delayed seeking care for 6 months or more after a positive HIV test. Women sought medical care earlier after testing (odds ratio (OR) = 1.79; P = 0.0227), but were already symptomatic (OR = 1.90; P = 0.0004). Partners of seropositive patients (OR = 3.92; P = 0.0000) also sought care symptomatic. Reasons for late presentation for care were non-acceptance of HIV diagnosis (OR = 24.56; P = 0.0000), treatment refusal (OR = 55.34; P = 0.0000), and physical disability (OR = 1.90; P = 0.0414). Necessary strategies for HIV treatment and prevention include improved education and access to services.

Resumen

Estudio estratificado muestra transversal cuantitativo (N = 1.520) de HIV/SIDA se llevó a cabo en São Paulo. Para el análisis de resultados, se utilizó la prueba de chi-cuadrado y regresión logística múltiple. Buscar cuidado con el SIDA fue 56.7 %(861), 48.2 % (732)con CD4 ≤350cel/mm3 y los sujetos que buscaban atención hasta seis meses después de la prueba del VIH fue del 9 % (136). Mujeres buscaban atención antes (OR = 1.79; P = 0.0227), pero ya enfermas (OR = 1.90; P = 0.0004). Compañeros de seropositivos buscaban atención enfermos (OR = 3.92; P = 0.0000). Las rasones eran: personas no aceptan el diagnóstico de VIH (OR = 24.56; P = 0.0000) y no quieren que se traten (OR = 55.34; P = 0.0000), deficiente físico (OR = 1.90; P = 0.0414). Estrategias necesarias incluyen educación y acceso a los servicios.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harrison KM, Song R, Zhang X. Life expectancy after HIV diagnosis based on national HIV surveillance data from 25 states, United States. J Acquir Immune Defic Syndr. 2010;53(1):124–30.

    Article  PubMed  Google Scholar 

  2. Egger M, May M, Chêne G, et al. Prognosis of HIV-1 infected patients starting highly active antiretroviral therapy: a collaborative analyses of prospective studies. Lancet. 2002;360:119–29.

    Article  PubMed  Google Scholar 

  3. Aberg JA, Gallant JE, Ghanem KG, Emanuel P, Zingman BS, Horberg MA. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58(1):e1–34.

    Article  PubMed  Google Scholar 

  4. Brazil Department of STD, AIDS and Viral Hepatitis. http://www.aids.gov.br. Accessed March 10, 2014. [In Portuguese].

  5. Epidemiological bulletin AIDS HIV/STD and B and C hepatitis of São Paulo city. 2010 (June); n13. [In Portuguese].

  6. HIV antiretroviral therapy recommendation. 7th ed. Brasília, Ministério da Saúde; 2008. [In Portuguese].

  7. Epidemiological bulletin AIDS HIV/SDT of São Paulo city. 2011 (June); n16. [In Portuguese].

  8. Reis AC, Santos EM, Cruz MM. A mortalidade por AIDS no Brasil: um estudo exploratório de sua evolução temporal. Epidemiol Serv Saúde Brasília. 2007;16(3):195–205.

    Google Scholar 

  9. Grangeiro A, Escuder MM, Menezes PR, Alencar R. Ayres de Castilho E. Late entry into HIV care: estimated impact on AIDS mortality rates in Brazil, 2003-2006. PLoS One. 2011;6(1):e14585.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Krentz HB, Auld MC, Gill MJ. The high cost medical care for patients who present late (CD4 <200 cel/ml) with HIV infection. HIV Med. 2004;5(2):93–8.

    Article  CAS  PubMed  Google Scholar 

  11. Carnicer-Pont D, de Olalla PG. Caylă JA; AIDS Working Group. HIV infection late detection in AIDS patients of a European city with increased immigration since mid-1990s. Curr HIV Res. 2009;7(2):237–43.

    Article  CAS  PubMed  Google Scholar 

  12. UNAIDS. Available at: http://www.unaids.org/en/resources/presscentre/featurestories/20131018brazil/. Accessed March 10, 2014.

  13. Adler A, Mounier-Jack S, Coker RJ. Late diagnosis of HIV in Europe: definitional and public health challenges. AIDS Care. 2009;21(3):284–93.

    Article  CAS  PubMed  Google Scholar 

  14. Fernandes JR, Acurcio Fde A, Campos LN, Guimarães MD. Início da terapia antirretroviral em estágio avançado de imunodeficiência entre indivíduos portadores de HIV/AIDS em Belo Horizonte, Minas Gerais, Brasil. Cad Saúde Pública. 2009;25(6):1369–80.

    Article  PubMed  Google Scholar 

  15. Girardi E, Aloisi MS, Arici C, ICoNA Behavioural Epidemiology Study Group, et al. Delayed presentation and late testing for HIV: demographic and behavioral risk factors in a multicenter study in Italy. J Acquir Immune Def Syndr. 2004;36(4):951–91.

    Article  Google Scholar 

  16. Bassicheto KC, Barbosa ASM, Abbate MC, et al. Improving the surveillance system of STD/AIDS specialized services in the city of São Paulo, Brazil. The XV International AIDS Conference: Abstract no.C11074.

  17. Castro KG, Ward JW, Slutsker L, Buehler JW, et al. 1993 Revised Classification System for HIV Infection and Expanded Surveillance case Definition for AIDS among Adolescents and Adults. Clin Infect Dis. 1993;17(4):802–10.

    Article  Google Scholar 

  18. Ndiaye B, Salleron J, Vincent A, et al. Factors associated with presentation to care with advanced HIV disease in Brussels and Northern France: 1997-2007. BMC Infect Dis. 2011;11:11.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Groce B. Levantamento mundial sobre HIV AIDS e deficiências. Available at: http://cira.med.yale.edu/globalsurvey>. [In Portuguese].

  20. Hibbard JH, Pope CR. Gender Roles, illness orientation and use medical services. Soc Sci Med. 1983;17(3):129–37.

    Article  CAS  PubMed  Google Scholar 

  21. Delpierre C, Dray-Spira R, Cuzin L, et al. VESPA Study Group. Correlates of late HIV diagnoses: implication for testing policy. Int J STD AIDS. 2007;18(5):312–7.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Vermund SH. Testing and linkage of patients to early care. AIDS. 2011;25:1547–8.

    Article  PubMed  Google Scholar 

  23. Deinno MCV, Farias N, Chencinshi J, Simões RN. Perfil dos usuários do serviço de aconselhamento no serviço de assistência especializada em DST/AIDS. Campos Elíseos, Município de São Paulo, Brasil. Bol Epidemiol Paulista. 2010;7(74):13–22.

    Google Scholar 

  24. Mor V, Fleishman JA, Dresser M, Piette J. Variation in health service use among HIV-infected patients. Med Care. 1992;30(1):17–29.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank the STD/AIDS National Program and Oswaldo Cruz Foundation for financial support.

Author information

Authors and Affiliations

  1. Universidade Federal de São Paulo, Bloc A1. 2nd Floor, Room 211, Av. Albert Einstein 627 Morumbi, São Paulo, SP, 05651-901, Brazil

    Zarifa Khoury, Rebeca S. Silva & Wilza Villela

Authors
  1. Zarifa Khoury
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rebeca S. Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wilza Villela
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zarifa Khoury.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khoury, Z., Silva, R.S. & Villela, W. Factors Associated with a Delay in Seeking HIV/AIDS Treatment in São Paulo, Brazil. AIDS Behav 19, 679–683 (2015). https://doi.org/10.1007/s10461-014-0885-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-014-0885-x

Keywords

Palabras clave

Search

Navigation