Late presentation for HIV care in central Haiti: factors limiting access to care

Louis, Christopher J.; Ivers, LC; Fawzi, Mary C. Smith; Freedberg, Kenneth A.; Castro, Arachu

doi:10.1080/09540120701203246

Cited by 36 publications

(30 citation statements)

References 15 publications

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“…15,16 In the present study we report similar results, but also found late diagnosis of HIV-1 to be frequent among Antillean and Surinam populations living in The Netherlands. This may indicate that Caribbean sociocultural factors are playing a role in the acknowledgment of risk factors for HIV infection.…”

Section: Discussionsupporting

confidence: 92%

The Efficacy of Combination Antiretroviral Therapy in HIV Type 1-Infected Patients Treated in Curaçao Compared with Antillean, Surinam, and Dutch HIV Type 1–Infected Patients Treated in The Netherlands

Hermanides¹,

Gras

Winkel

et al. 2011

AIDS Research and Human Retroviruses

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We compared the efficacy of combination antiretroviral therapy (cART) of Antillean HIV-1-infected patients treated on the Caribbean island of Curaçao (CUR-AN) with Antillean (NL-AN), Surinam (NL-SUR), and Dutch (NL-NL) patients treated in The Netherlands. In total 2118 therapy-naive patients who started cART between January 2005 and August 2008 were included in the comparison. The CUR-AN patients initiated cART at a median CD4 cell count of 141 cells/mm(3) and 63% had counts below 200 cells/mm(3). Within 12 months of the start of cART 76% of the CUR-AN patients achieved viral suppression, defined as HIV-1 RNA plasma levels below 80 copies/ml. The percentage achieving viral suppression was higher in patients treated in The Netherlands (NL-AN = 87%, NL-SUR = 93%, and NL-NL = 96%). Lost to follow-up after 30 months of cART was 10% among CUR-AN patients and was higher than observed among patients treated in The Netherlands (NL-AN = 8%, NL-SUR = 3%, and NL-NL = 2%). A similar pattern was found for progression to AIDS and death (10% of CUR-AN vs. 5%, 6%, and 7% of NL-AN, NL-SUR, and NL-NL patients, respectively). Late start of cART and limited viral suppression after the start of cART determine the higher rate of disease progression to AIDS and death among Antillean patients treated in Curaçao. The high percentage of lost to follow-up may result in an underestimation of AIDS and AIDS-related death among HIV-1-infected Antilleans treated in Curaçao.

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Section: Discussionsupporting

confidence: 92%

The Efficacy of Combination Antiretroviral Therapy in HIV Type 1-Infected Patients Treated in Curaçao Compared with Antillean, Surinam, and Dutch HIV Type 1–Infected Patients Treated in The Netherlands

Hermanides¹,

Gras

Winkel

et al. 2011

AIDS Research and Human Retroviruses

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“…Reports from the U.S. indicate that one-third to nearly half of individuals diagnosed with HIV during client-initiated HIV testing delay entry into care for more than 1 year (Glynn, 2005; Samet et al, 1998). Similar rates of delayed access to care have been observed in developing countries with universal access to HIV care and treatment (Kumar, Kilaru, Kumari, Forde, & Waterman, 2008; Louis, Ivers, Smith Fawzi, Freedberg, & Castro, 2007). …”

supporting

confidence: 63%

Provider-initiated HIV testing in health care settings: Should it include client-centered counselling?

Kiene

Bateganya

Wanyenze

et al. 2009

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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To increase access to HIV-testing the WHO and CDC have recommended implementing provider-initiated HIV-testing (PITC). To address the resource limitations of the PITC setting WHO and CDC suggest that patient-provider interactions during PITC may need to focus on providing information and referrals instead of engaging patients in client-centered counseling as is recommended during client-initiated HIV-testing. Providing HIV-prevention information has been shown to be less effective than client-centered counseling at reducing HIV-risk behavior and STI incidence. Therefore, concerns exist about the efficacy of PITC as an HIV-prevention approach. However, reductions in HIV incidence may be larger if more people know their HIV-status through expanded availability of PITC, even if PITC is less effective than is client-initiated HIV-testing for individual patients. In the absence of an answer to this public health question, adaptation of effective brief client-centered counseling approaches to PITC should be explored along with research assessing the efficacy of PITC.

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“…This is mirrored by the desire of the clients interviewed for availability of food, drugs, and even money to facilitate successful access to health care, while lack of the same were listed as barriers to accessing health care. Low socioeconomic status, poverty, and unemployment have been cited as major reasons for delay in accessing care by HIV-infected patients in previous studies (Joy et al, 2008; Kiwanuka et al, 2008; Louis, Ivers, Smith Fawzi, Freedberg, & Castro, 2007). …”

Section: Discussionmentioning

confidence: 93%

Determinants of failure to access care in mothers referred to HIV treatment programs in Nairobi, Kenya

et al. 2010

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Background As prevention of mother-to-child transmission of HIV (PMTCT) programs and HIV treatment programs rapidly expand in parallel, it is important to determine factors that influence the transition of HIV-infected women from maternal to continuing care. Design This study aimed to determine rates and co-factors of accessing HIV care by HIV-infected women exiting maternal care. A cross-sectional survey of women who had participated in a PMTCT research study and were referred to care programs in Nairobi, Kenya was conducted. Methods A median of 17 months following referral, women were located by peer counselors and interviewed to determine whether they accessed HIV care and what influenced their care decisions. Fisher’s exact test was used to assess the association between client characteristics and access to care. Results Peer counselors traced 195 (82%) residences, where they located 116 (59%) participants who provided information on care. Since exit, 50% of participants had changed residence, and 74% reported going to the referral HIV program. Reasons for not accessing care included lack of money, confidentiality, and dislike of the facility. Women who did not access care were less likely to have informed their partner of the referral (p=0.001), and were less likely believe that highly active antiretroviral therapy (HAART) is effective (p<0.01). Among those who accessed care, 33% subsequently discontinued care, most because they did not qualify for HAART. Factors cited as barriers to access included stigma, denial, poor services, and lack of money. Factors that were cited as making care attractive included health education, counseling, free services, and compassion. Conclusion A substantial number of women exiting maternal care do not transit to HIV care programs. Partner involvement, a standardized referral process and more comprehensive HIV education for mothers diagnosed with HIV during pregnancy may facilitate successful transitions between PMTCT and HIV care programs.

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Late presentation for HIV care in central Haiti: factors limiting access to care

Cited by 36 publications

References 15 publications

The Efficacy of Combination Antiretroviral Therapy in HIV Type 1-Infected Patients Treated in Curaçao Compared with Antillean, Surinam, and Dutch HIV Type 1–Infected Patients Treated in The Netherlands

The Efficacy of Combination Antiretroviral Therapy in HIV Type 1-Infected Patients Treated in Curaçao Compared with Antillean, Surinam, and Dutch HIV Type 1–Infected Patients Treated in The Netherlands

Provider-initiated HIV testing in health care settings: Should it include client-centered counselling?

Determinants of failure to access care in mothers referred to HIV treatment programs in Nairobi, Kenya

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