HIV testing patterns: where, why, and when were persons with AIDS tested for HIV?

Wortley, Pascale M.; Chu, Susan Y.; Diaz, Theresa; Ward, John W.; Doyle, Brian; Davidson, Arthur J.; Checko, Patricia J.; Herr, Marie; Conti, Lisa; Fann, Stephen A.

doi:10.1097/00002030-199509050-00011

Cited by 158 publications

(45 citation statements)

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“…In this regard, our findings reflect those reported elsewhere (e.g., Stein et al 1991, Wortley et al 1995, Couturier et al 1998, Lessells et al 2011) with respect to the importance of symptoms. Study participants sought medical care when they were sick: being at known risk or known HIV status was less important in care seeking than symptoms that disrupt daily living .…”

Section: Discussion and Recommendationssupporting

confidence: 92%

“…Numerous studies have identified variables which contribute to sometimes quite lengthy delays in seeking HIV testing (e.g., Stein et al 1991, Wortley et al 1995, Couturier et al 1998) and in seeking medical care after testing (e.g., Godfrey-Faussett et al 2002). These factors include: history of drug use, poor social support, lack of perceived risk (Samet et al 1998, Samet et al 2001), or demographic characteristics (Girardi et al 2000, Hocking et al 2000, Meredith et al 2001, Klein et al 2003), and health sector factors such as lack of insurance (Milberg et al 2001, Turner et al 2000), not having a regular source of care (Turner et al 2000), dislike of provider approaches (Mallinson et al 2007), or physician failure to assess risk (Klein et al 2003).…”

Section: Introductionmentioning

confidence: 99%

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‘Slipping through the cracks’: Policy implications of delays in HIV treatment seeking

McGrath¹,

Kaawa-Mafigiri²,

Bridges³

et al. 2012

Global Public Health

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Public health initiatives to “test and treat” HIV infected persons require understanding HIV care seeking. A study of 101 HIV infected women receiving anti-retroviral medications in Kampala, Uganda examined barriers to HIV care. Participants entered HIV/AIDS care late, despite knowing their risk and having sought care for symptoms. Over half the participants (51%) reported delays of up to 5 years from when they suspected they were infected to seeking an HIV test. Some women reported that they did not perceive a need to be tested since they “knew” they had HIV due to their partner’s death from AIDS. Once tested, delays in entering HIV specific care ranged from less than 6 months to over 5 years. The most common reason reported for entering HIV care was the occurrence of serious or persistent symptoms. Late presentation for HIV care in this cohort is due to the inability of the medical system to link women to appropriate care. Women “slip through the cracks” of this system, despite their care seeking behaviours. The inability to provide linkage to care is a challenge at the health system level that threatens the hoped for success of “test and treat” protocols.

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Section: Discussion and Recommendationssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

‘Slipping through the cracks’: Policy implications of delays in HIV treatment seeking

McGrath¹,

Kaawa-Mafigiri²,

Bridges³

et al. 2012

Global Public Health

View full text Add to dashboard Cite

show abstract

“…Efforts to routinize HIV testing began nearly a decade ago in response to epidemiologic trends indicating at least 20% of HIV-infected persons are unaware of their HIV-positive status and risk-based screening (i.e., only testing people who report risk behaviors or risk group membership) misses cases of undiagnosed HIV infection among people presumed to have minimal HIV risk (Chen et al, 2012; Duffus et al, 2009; MacKellar et al, 2005). Nationwide HIV testing is available at low cost or free at county and municipal public health venues throughout the nation (Centers for Disease Control and Prevention, 2001; Wortley et al, 1995). Routine testing is an efficient, cost-effective way to identify undiagnosed HIV infections (Bos, van der Meijden, Swart, & Postma, 2002; Paltiel et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

HIV testing among clients in high HIV prevalence venues: disparities between older and younger adults

Ford

Lee

Wallace³

et al. 2014

AIDS Care

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The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus (HIV) testing of every client presenting for services in venues where HIV prevalence is high. Because older adults (age>50 years) have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent (past 12 months) and ever HIV testing in a probability sample of at-risk adults (N=1,238) seeking services in needle exchange sites, sexually transmitted disease clinics and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category (<50 years vs. >50 years) and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months (OR=0.6; 95% CI=0.40–0.90) or ever (OR=0.6; 95% CI=0.40–0.90). Aging-related disparities in HIV testing exist in these high HIV prevalence venues, and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis.

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“…This situation mirrors the 1992 National Health Interview Survey finding that 63% of those reporting risk of infection have not been tested (Wortley et al, 1995). Among the two million who do get tested, a fourth of those who are infected do not return for their results (CDC, 1996).…”

Section: Changing Clinical Standardsmentioning

confidence: 89%

AIDS and Drug Use: Where are we Headed?

Bennett¹

1996

Journal of Addictions Nursing

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HIV testing patterns: where, why, and when were persons with AIDS tested for HIV?

Cited by 158 publications

References 0 publications

‘Slipping through the cracks’: Policy implications of delays in HIV treatment seeking

‘Slipping through the cracks’: Policy implications of delays in HIV treatment seeking

HIV testing among clients in high HIV prevalence venues: disparities between older and younger adults

AIDS and Drug Use: Where are we Headed?

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