Barriers to early diagnosis and treatment of severely immunosuppressed patients with HIV-1 infection: A quantitative and qualitative study

Liu, J. Y.1,2; Sun, L. Q.1,2; Hou, Y. Y.3,4; Wang, L. F.4; He, Y.1,2; Zhou, Y.1,2; Xu, L. M.1,2; Wang, H.1,2; Wang, F. S.3,4

2020-12-01

10.1111/hiv.13028

HIV MEDICINE   影响因子和分区

1464-2662

1468-1293

["Objectives To explore the barriers to early diagnosis of HIV infection and timely initiation of antiretroviral therapy (ART).","Methods We assessed the annual number and proportion of ART-naive people living with HIV infection (PLWH) with severe immunosuppression in Shenzhen, China, from 2008 to 2019. Selected ART-naive PLWHs with severe immunosuppression who were seeking treatment for the first time in the hospital in 2019 were subjected to an in-depth interview.","Results The proportion of severely immunosuppressed, ART-naive PLWH decreased from 36.73% in 2008 to 8.94% in 2015, and then plateaued at approximately 10% from 2015 to 2019. Overall, 55 patients, 70% of whom were men who had sex with men, participated in the qualitative interviews. Ten of them delayed treatment after diagnosis, with a median [interquartile range (IQR)] interval of 5.83 (3.98-8.54) years between diagnosis and ART. More than 80% of the patients reported casual sexual contact within a median period of 6 years and with a median (IQR) of nine (4-20) casual sex partners. The major barriers to HIV testing and diagnosis included lack of knowledge about HIV and high-risk behaviours, low awareness about HIV testing, and resistance to HIV testing. The major barriers to ART initiation included lack of knowledge about the importance of ART and change of national ART eligibility policy, and HIV-related stress.","Conclusions The number of PLWHs with severe immunosuppression who seek treatment remains high in Shenzhen, China. Thus, current HIV-related care programmes targeting access to early diagnosis and treatment need to be improved."]

antiretroviral therapy care cascade HIV testing late presentation stigma

SCI

英语

第一 ; 通讯

Sanming Project of Medicine in Shenzhen[SZSM201612014] ; China Postdoctoral Science Foundation[2019M660840]

Infectious Diseases

Infectious Diseases

WOS:000601609600005

WILEY

IMMUNOLOGY

Web of Science

1.Southern Univ Sci & Technol, Natl Clin Res Ctr Infect Dis, Peoples Hosp Shenzhen 3, Shenzhen 518100, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 2, Shenzhen 518100, Guangdong, Peoples R China
3.Med Sch Chinese PLA, Beijing, Peoples R China
4.Peoples Liberat Army Gen Hosp, Treatment & Res Ctr Infect Dis, Med Ctr 5, Beijing, Peoples R China

Liu, J. Y.,Sun, L. Q.,Hou, Y. Y.,et al. Barriers to early diagnosis and treatment of severely immunosuppressed patients with HIV-1 infection: A quantitative and qualitative study[J]. HIV MEDICINE,2020,21(11).

Liu, J. Y..,Sun, L. Q..,Hou, Y. Y..,Wang, L. F..,He, Y..,...&Wang, F. S..(2020).Barriers to early diagnosis and treatment of severely immunosuppressed patients with HIV-1 infection: A quantitative and qualitative study.HIV MEDICINE,21(11).

Liu, J. Y.,et al."Barriers to early diagnosis and treatment of severely immunosuppressed patients with HIV-1 infection: A quantitative and qualitative study".HIV MEDICINE 21.11(2020).