VA Connecticut Healthcare System, Yale Schools of Medicine and Public Health, Yale University, West Haven, CT, USA.
VA Greater Los Angeles Healthcare System, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
Lancet HIV. 2022 Apr;9(4):e269-e280. doi: 10.1016/S2352-3018(22)00003-0. Epub 2022 Feb 23.
Late presentation for care is a major impediment to the prevention and effective treatment of HIV infection. Older individuals are at increased risk of late presentation, represent a growing proportion of people with late presentation, and might require interventions tailored to their age group. We provide a summary of the literature published globally between 2016-21 (reporting data from 1984-2018) and quantify the association of age with delayed presentation. Using the most common definitions of late presentation and older age from these earlier studies, we update this work with data from the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium, focusing on data from 2000-19, encompassing four continents. Finally, we consider how late presentation among older individuals might be more effectively addressed as electronic medical records become widely adopted.
就诊延迟是艾滋病预防和有效治疗的主要障碍。老年人更有可能出现就诊延迟,且他们在出现就诊延迟的人群中占比不断增加,因此可能需要针对其年龄组的干预措施。我们对 2016 年至 2021 年(报告 1984 年至 2018 年的数据)期间在全球发表的文献进行了总结,并量化了年龄与延迟就诊之间的关系。我们使用这些早期研究中最常见的就诊延迟和老年定义,利用国际艾滋病流行病学数据库评估联盟(IeDEA 联盟)的数据对此项工作进行了更新,重点关注 2000 年至 2019 年的数据,涵盖了四大洲。最后,我们考虑了随着电子病历的广泛应用,如何更有效地解决老年人的就诊延迟问题。