Unmatched Case-Control Study on Late Presentation of HIV Infection in Santiago, Cape Verde (2004-2011)

• Published in: International journal of environmental research and public health Vol. 13; no. 3; p. 320
• Main Authors: Moreira, António L, Fronteira, Inês, Augusto, Gonçalo Figueiredo, Martins, Maria Rosario O
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 15.03.2016; MDPI
• Subjects: Acquired immune deficiency syndrome; Adult; Aged; Aged, 80 and over; AIDS; Anti-Retroviral Agents - therapeutic use; Antiretroviral agents; Antiretroviral therapy; Cabo Verde - epidemiology; Case-Control Studies; CD4 antigen; Confidence intervals; Demographics; Drug therapy; Early Diagnosis; Female; Health care; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infections; Male; Medical diagnosis; Medical tests; Middle Aged; Patient Acceptance of Health Care; Patients; Population; Risk Factors; Statistical analysis; Time Factors; Womens health; Young Adult; Rio de Janeiro Brazil; Cape Verde Islands; United Kingdom > UK; Sub-Saharan Africa; HIV/AIDS; Cape Verde; late presentation; CD4 count
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph13030320

Access to free antiretroviral therapy (ART) in Sub-Saharan Africa has been steadily increasing over the past decade. However, the success of large-scale ART programmes depends on timely diagnosis and early initiation of HIV care. This study characterizes late presenters to HIV care in Santiago (Cape Verde) between 2004 and 2011, and identifies factors associated with late presentation for care. We defined late presentation as persons presenting to HIV care with a CD4 count below 350 cells/mm³. An unmatched case-control study was conducted using socio-demographic and behavioural data of 368 individuals (191 cases and 177 controls) collected through an interviewer-administered questionnaire, comparing HIV patients late and early presented to care. Logistic regression was performed to estimate odds ratio and 95% confidence intervals. Results show that 51.9% were late presenters for HIV. No differences were found in gender distribution, marital status, or access to health services between cases and controls. Participants who undertook an HIV test by doctor indication were more likely to present late compared with those who tested for HIV by their own initiative. Also, individuals taking less time to initiate ART are more likely to present late. This study highlights the need to better understand reasons for late presentation to HIV care in Cape Verde. People in older age groups should be targeted in future approaches focused on late presenters to HIV care.