Factors associated with delayed and late ART initiation among people living with HIV in BC: results from the engage study.

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  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 8915313 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0451 (Electronic) Linking ISSN: 09540121 NLM ISO Abbreviation: AIDS Care Subsets: MEDLINE
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: Abingdon, Oxfordshire, U.K. : Carfax Pub. Co., c1989-
    • Subject Terms:
      Time-to-Treatment*; Anti-HIV Agents/*therapeutic use ; CD4 Lymphocyte Count/*statistics & numerical data ; Delayed Diagnosis/*statistics & numerical data ; HIV Infections/*drug therapy; Adult ; Antiretroviral Therapy, Highly Active ; British Columbia ; Cohort Studies ; Female ; HIV Infections/diagnosis ; HIV Infections/immunology ; Humans ; Male ; Marital Status ; Middle Aged ; Prospective Studies ; Time Factors
    • Abstract:
      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.
    • Grant Information:
      259240 Canada CAPMC CIHR
    • Contributed Indexing:
      Keywords: ART; HIV; linkage to care; treatment initiation
    • Accession Number:
      0 (Anti-HIV Agents)
    • Publication Date:
      Date Created: 20181124 Date Completed: 20200304 Latest Revision: 20200304
    • Publication Date:
      20221213
    • Accession Number:
      10.1080/09540121.2018.1549722
    • Accession Number:
      30466303