Epidemiological characteristics and predictors of late presentation of HIV infection in Barcelona (Spain) during the period 2001-2009.docVIP

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Epidemiological characteristics and predictors of late presentation of HIV infection in Barcelona (Spain) during the period 2001-2009.doc

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Epidemiological characteristics and predictors of late presentation of HIV infection in Barcelona (Spain) during the period 2001-2009

deOlallaetal.AIDSResearchandTherapy2011,8:22 /content/8/1/22 RESEARCH OpenAccess Epidemiologicalcharacteristicsandpredictorsof latepresentationofHIVinfectioninBarcelona (Spain)duringtheperiod2001-2009 PatriciaGarciadeOlalla1,2*,ChristianManzardo3,MariaASambeat4,InmaOca?a5,HernandoKnobel6, VictoriaHumet7,PereDomingo4,EsteveRibera5,AnaGuelar6,AndresMarco7,MariaJBelza2,8,JosepMMiró3, JoanACaylà1,2 andfortheHIVSurveillanceGroup Abstract Background:EarlydiagnosisofHIVinfectioncanpreventmorbidityandmortalityaswellasreduceHIV transmission.Theaimofthepresentstudywastoassessprevalence,describetrendsandidentifyfactorsassociated withlatepresentationofHIVinfectioninBarcelona(Spain)duringtheperiod2001-09. Methods:DemographicandepidemiologicalcharacteristicsofcasesreportedtotheBarcelonaHIVsurveillance systemwereanalysed.LatepresentationwasdefinedforindividualswithaCD4countbelow350cells/mlupon HIVdiagnosisordiagnosisofAIDSwithin3monthsofHIVdiagnosis.Multivariatelogisticregressionwereusedto identifypredictorsoflatepresentation. Results:Ofthe2,938newlydiagnosedHIV-infectedindividuals,2,507(85,3%)hadeitheraCD4cellcountoran AIDSdiagnosisavailable.Atotalof1,139(55.6%)ofthe2,507studiedcasesoverthesenineyearswerelate presentersvaryingfrom48%amongmenwhohavesexwithmento70%amongheterosexualmen.The proportionoflatepresentationwas62.7%in2001-2003,51.9%in2004-2005,52.6%in2006-2007and52.1%in 2008-2009.Adecreaseovertimeonlywasobservedbetween2001-2003and2004-2005(p=0.001)butremained constantthereafter(p=0.9).Independentriskfactorsforlatepresentationwereolderageatdiagnosis(p 0.0001),useofinjecteddrugsbymen(p0.0001),beingaheterosexualmen(p0.0001),andbeingbornin SouthAmerica(p0.0001)orsub-SaharanAfrica(p=0.002). Conclusion:LatepresentationofHIVisstilltoofrequentinalltransmissiongroupsinspiteofastrong commitmentwithHIVpreventioninourcity.ItisnecessarytodevelopinterventionsthatincreaseHIVtestingand facilitateearlierentryintoHIVcare. Keywords:HIVinfection,Latepresentation,Epidemiology,Predictors,Bar