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Trends and predictors of linkage to HIV outpatient care following diagnosis in the era of expanded testing in England, Wales and Northern Ireland: Results of a national cohort study.
- Source :
-
HIV Medicine . Jul2021, Vol. 22 Issue 6, p491-501. 11p. - Publication Year :
- 2021
-
Abstract
- Objectives: We explore trends in linkage to HIV care following diagnosis and investigate the impact of diagnosis setting on linkage in the era of expanded testing. Methods: All adults (aged ≥ 15 years) diagnosed with HIV between 2005 and 2014 in England, Wales and Northern Ireland (EW&NI) were followed up until the end of 2017. People who died within 1 month of diagnosis were excluded (n = 1009). Trends in linkage to outpatient care (time to first CD4 count) were examined by sub‐population and diagnosis setting. Logistic regression identified predictors of delayed linkage of > 1 month, > 3 months and > 1 year post‐diagnosis (2012–2014). Results: Overall, 97% (60 250/62 079) of people linked to care; linkage ≤ 1 month was 75% (44 291/59 312), ≤ 3 months was 88% (52 460) and ≤ 1 year was 95% (56 319). Median time to link declined from 15 days [interquartile range (IQR): 4–43] in 2005 to 6 (IQR: 0–20) days in 2014 (similar across sub‐populations/diagnosis settings). In multivariable analysis, delayed linkage to care was associated with acquiring HIV through injecting drug use, heterosexual contact or other routes compared with sex between men (> 1 month/3 months/1 year), being diagnosed in earlier years (> 1 month/3 months/1 year) and having a first CD4 ≥ 200 cells/μL (> 3 months/1 year). Diagnosis outside of sexual health clinics, antenatal services and infectious disease units predicted delays of > 1 month. By 3 months, only diagnosis in 'other' settings (prisons, drug services, community and other medical settings) was significant. Conclusions: Linkage to care following HIV diagnosis is relatively timely in EW&NI. However, non‐traditional testing venues should have well‐defined referral pathways established to facilitate access to care and treatment. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14642662
- Volume :
- 22
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- HIV Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 150698487
- Full Text :
- https://doi.org/10.1111/hiv.13078