肯尼亚西部与艾滋病病毒治疗延迟参与相关的因素：一项横断面研究。
Factors Associated with Late Engagement to HIV Care in Western Kenya: A Cross-Sectional Study.
作者信息
Kwobah Charles Meja, Braitstein Paula, Koech Julius K, Simiyu Gilbert, Mwangi Ann W, Wools-Kaloustian Kara, Siika Abraham M
机构信息
Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya.
出版信息
J Int Assoc Provid AIDS Care. 2016 Nov;15(6):505-511. doi: 10.1177/2325957414567682. Epub 2015 Jan 14.
BACKGROUND
Late presentation of patients contributes significantly to the high mortality reported in HIV -care and treatment programs in sub-Saharan Africa.
METHODS
A cross-sectional study was conducted to assess factors associated with late engagement to HIV care at the Academic Model Providing Access to Healthcare in western Kenya. Late engagement was defined as baseline CD4 ≤100 cells/mm.
RESULTS
Of the 10 533 participants included in the analysis, 67% were female and mean age was 36.7 years. Overall, 23% of the participants presented late. Factors associated with late engagement included male gender (adjusted odds ratio [AOR]: 1.54, 95% confidence interval [CI]: 1.35-1.75), older age (AOR: 1.62, 95% CI: 1.02-2.56), and longer travel time to clinic (AOR: 1.18, 95% CI: 1.04-1.34).
CONCLUSION
Nearly one-quarter of HIV-infected patients in our setting present with advanced immune suppression at initial encounter. Being male, older age, and living further away from clinic are associated with late engagement to care.
背景
在撒哈拉以南非洲地区的艾滋病护理和治疗项目中，患者就诊延迟是导致高死亡率的重要因素。
方法
在肯尼亚西部提供医疗服务的学术模式下，开展了一项横断面研究，以评估与艾滋病护理延迟参与相关的因素。延迟参与被定义为基线CD4≤100个细胞/立方毫米。
结果
纳入分析的10533名参与者中，67%为女性，平均年龄为36.7岁。总体而言，23%的参与者就诊延迟。与延迟参与相关的因素包括男性（调整后的优势比[AOR]：1.54，95%置信区间[CI]：1.35 - 1.75）、年龄较大（AOR：1.62，95%CI：1.02 - 2.56）以及到诊所的出行时间较长（AOR：1.18，95%CI：1.04 - 1.34）。
结论
在我们的研究环境中，近四分之一的艾滋病感染患者在初次就诊时就出现了严重的免疫抑制。男性、年龄较大以及居住离诊所较远与延迟接受护理有关。
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