title: Late diagnosis of HIV infection in women seeking counseling and testing services in São Paulo, Brazil.
abstract: We investigated whether women positive for human immunodeficiency virus (HIV) infection were late in seeking an anonymous HIV counseling and testing service, and the factors associated with a low CD4 count, in São Paulo, Brazil. Seventy-one consecutive HIV-1-seropositive women were interviewed by means of a structured questionnaire. Blood samples were collected for CD4+ T-lymphocytes count and determination of HIV-1 subtypes. Hepatitis C, syphilis, human T-cell lymphotrophic virus type I (HTLV-I), and HTLV-II infections were assessed by serologic tests. More than 70% of the women had less than 500 CD4+ cells/mm3 (20% below 200). Low CD4 count was significantly associated with sex work history, condom use in the last 6 months, and seropositivity to HTLV-I and syphilis. There was no relation between low CD4 count and HIV-1 subtypes. These results indicate that in Sao Paulo many women are seeking an anonymous testing service late in the course of HIV infection. The main purposes of anonymous HIV testing services - early diagnosis of infection, and counseling to prevent infection - are not being achieved. Another strategy for reducing the interval between infection and diagnosis in women must be addressed.
authors.affiliation: Departamento de Medicina Preventiva-Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: C G
authors.initials: CG
authors.lastname: Luppi
authors.forename: J
authors.initials: J
authors.lastname: Eluf-Neto
authors.forename: E
authors.initials: E
authors.lastname: Sabino
authors.forename: V
authors.initials: V
authors.lastname: Buccheri
authors.forename: C
authors.initials: C
authors.lastname: Barreto
authors.forename: A B
authors.initials: AB
authors.lastname: Ungaro
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D015497:HIV-1; D015490:HTLV-I Infections / Q000150:complications / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000150:complications / Q000453:epidemiology; D016387:Women's Health