title: Risk factors for delayed access to specialized care in French Guiana.
abstract: The variables influencing the interval between diagnosis and effective access to specialized care were studied in a cohort of 2,661 human immunodeficiency virus (HIV)-positive patients in French Guiana between 1992 and 2008. Patients with a subsequent follow-up interruption were significantly more likely to have a delayed first consultation after the HIV diagnosis. Ordinal logistic regression showed that younger persons, women, and French citizens were independently associated with greater delays between the HIV diagnosis and the first specialized consultation. However, persons with acquired immunodeficiency syndrome (AIDS) were less likely to have a delay between the HIV diagnosis and the first specialized consultation. Focusing on the link between the private sector and specialized health care may shorten delays and improve care and follow-up.
authors.affiliation: Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana. mathieu.nacher@ch-cayenne.fr
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
authors.forename: Leila
authors.initials: L
authors.lastname: Adriouch
authors.forename: Antoine
authors.initials: A
authors.lastname: Adenis
authors.forename: Matthieu
authors.initials: M
authors.lastname: Hanf
authors.forename: Astrid
authors.initials: A
authors.lastname: Van Melle
authors.forename: Marie Claire
authors.initials: MC
authors.lastname: Parriault
authors.forename: Mélanie
authors.initials: M
authors.lastname: Calvez
authors.forename: Julie
authors.initials: J
authors.lastname: Dufour
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Papot
authors.forename: Vincent
authors.initials: V
authors.lastname: Vantilcke
authors.forename: Pierre
authors.initials: P
authors.lastname: Couppié
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005616:French Guiana; D015658:HIV Infections / Q000188:drug therapy*; D006297:Health Services Accessibility; D012307:Risk Factors