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德国 HIV 晚期就诊的社会人口学和心理社会决定因素——来自 FindHIV 研究的结果。

Socio-demographic and psycho-social determinants of HIV late presentation in Germany - results from the FindHIV study.

机构信息

MUC Research GmbH, Munich, Germany.

German Association of Physicians specialized in HIV Care (dagnae) e.V., Berlin, Germany.

出版信息

AIDS Care. 2023 Nov;35(11):1749-1759. doi: 10.1080/09540121.2023.2185196. Epub 2023 Mar 13.

DOI:10.1080/09540121.2023.2185196
PMID:36912672
Abstract

Delayed HIV diagnosis at advanced stages of disease remains common (33%-64%). This analysis of the multi-center FindHIV study including newly diagnosed HIV-infected adults in Germany, focused on the potential role of socio-demographic and psychological factors on late diagnosis (formerly "late presentation", AIDS diagnosis or CD4 cells <350/µL). These data were collected from patient profiles, physician-patient interviews and questionnaires. Participating centers ( = 40) represented the diverse health care settings in HIV care and geographic regions. Of 706 newly diagnosed adults (92% male, median age 39 years) between 2019 and 2020, 55% (388/706) were diagnosed late with a median CD4 cell count of 147/µL; 20% (142/706) presented with AIDS. From the physicians' perspective, earlier diagnosis would have been possible in 45% of participants (late versus non-late presentation 58% versus 29%). The most common physician-perceived reason was an underestimated risk for HIV infection by the patient (37%). In multivariable logistic regression analysis, older age, sexual contacts with both sexes as possible route of HIV transmission, being married, and a poor level of knowledge about HIV treatment were found to be associated with a significantly elevated risk for late presentation. Education, employment status, sexual relations, migration background and personality traits were not.: German Clinical Trials Register (DRKS00016351).

摘要

在疾病的晚期仍普遍存在延迟的 HIV 诊断(33%-64%)。这项对包括德国新诊断的 HIV 感染者在内的多中心 FindHIV 研究的分析,重点关注了社会人口学和心理因素对晚期诊断(以前称为“晚期表现”、艾滋病诊断或 CD4 细胞 <350/µL)的潜在作用。这些数据是从患者档案、医患访谈和问卷调查中收集的。参与的中心( = 40)代表了 HIV 护理中的各种医疗保健环境和地理区域。在 2019 年至 2020 年间,706 名新诊断的成年人(92%为男性,中位年龄 39 岁)中,55%(388/706)被诊断为晚期,中位 CD4 细胞计数为 147/µL;20%(142/706)出现艾滋病。从医生的角度来看,45%的参与者(晚期与非晚期表现为 58%与 29%)本可以更早诊断。医生认为最常见的原因是患者低估了 HIV 感染的风险(37%)。在多变量逻辑回归分析中,年龄较大、与两种性别的性接触可能是 HIV 传播途径、已婚以及对 HIV 治疗的知识水平较差,与晚期表现的风险显著增加相关。教育、就业状况、性关系、移民背景和人格特征则不然。

该研究已在德国临床试验注册处(DRKS00016351)注册。

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