Distance to testing sites and its association with timing of HIV diagnosis*
| العنوان: | Distance to testing sites and its association with timing of HIV diagnosis* |
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| المؤلفون: | Peter A. Leone, Kimberly A. Powers, Anna B. Cope, Veronica Escamilla, Victoria Mobley, Marc L. Serre, Michael Emch, William C. Miller |
| المصدر: | AIDS Care. 28:1423-1427 |
| بيانات النشر: | Informa UK Limited, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, Pediatrics, medicine.medical_specialty, Delayed Diagnosis, Time Factors, Health (social science), Social Psychology, HIV diagnosis, Human immunodeficiency virus (HIV), HIV Infections, Optical density, medicine.disease_cause, Health Services Accessibility, Article, Young Adult, 03 medical and health sciences, 0302 clinical medicine, North Carolina, Humans, Medicine, 030212 general & internal medicine, Homosexuality, Male, Young adult, Medical diagnosis, Generalized estimating equation, 030505 public health, business.industry, Transmission (medicine), Public Health, Environmental and Occupational Health, HIV, virus diseases, Patient Acceptance of Health Care, Confidence interval, Black or African American, Early Diagnosis, Immunology, RNA, Viral, Female, 0305 other medical science, business, human activities |
| الوصف: | Early HIV diagnosis enables prompt treatment initiation, thereby contributing to decreased morbidity, mortality, and transmission. We aimed to describe the association between distance from residence to testing sites and HIV disease stage at diagnosis. Using HIV surveillance data, we identified all new HIV diagnoses made at publicly funded testing sites in central North Carolina during 2005-2013. Early-stage HIV was defined as acute HIV (antibody-negative test with a positive HIV RNA) or recent HIV (normalized optical density0.8 on the BED assay for non-AIDS cases); remaining diagnoses were considered post-early-stage HIV. Street distance between residence at diagnosis and (1) the closest testing site and (2) the diagnosis site was dichotomized at 5 miles. We fit log-binomial models using generalized estimating equations to estimate prevalence ratios (PR) and robust 95% confidence intervals (CI) for post-early-stage diagnoses by distance. Models were adjusted for race/ethnicity and testing period. Most of the 3028 new diagnoses were black (N = 2144; 70.8%), men who have sex with men (N = 1685; 55.7%), and post-early-stage HIV diagnoses (N = 2010; 66.4%). Overall, 1145 (37.8%) cases traveled5 miles for a diagnosis. Among cases traveling ≥5 miles for a diagnosis, 1273 (67.6%) lived5 miles from a different site. Residing ≥5 miles from a testing site was not associated with post-early-stage HIV (adjusted PR, 95% CI: 0.98, 0.92-1.04), but traveling ≥5 miles for a diagnosis was associated with higher post-early HIV prevalence (1.07, 1.02-1.13). Most of the elevated prevalence observed in cases traveling ≥5 miles for a diagnosis occurred among those living5 miles from a different site (1.09, 1.03-1.16). Modest increases in post-early-stage HIV diagnosis were apparent among persons living near a site, but choosing to travel longer distances to test. Understanding reasons for increased travel distances could improve accessibility and acceptability of HIV services and increase early diagnosis rates. |
| تدمد: | 1360-0451 0954-0121 |
| DOI: | 10.1080/09540121.2016.1191599 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::296f97ec5271b9c008ee1989ed29e968 https://doi.org/10.1080/09540121.2016.1191599 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....296f97ec5271b9c008ee1989ed29e968 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13600451 09540121 |
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| DOI: | 10.1080/09540121.2016.1191599 |