Predictors of late presentation for HIV diagnosis: a literature review and suggested way forward.
Early commencement of antiretroviral treatment can be beneficial and economical in the long run. Despite global advances in access to care, a significant proportion of adults presenting at HIV/AIDS care facilities present with advanced HIV disease. Understanding factors associated with late presentation for HIV/AIDS services is critical to the development of effective programs and treatment strategies. Literature on factors associated with late presentation for an HIV diagnosis is reviewed. Highlighted is the current emphasis on socio-demographic factors, the limited exploration of psychosocial correlates, and inconsistencies in the definition of late presentation that make it difficult to compare findings across different studies. Perspectives based on experiences from resource limited settings are underreported. Greater exploration of psychosocial predictors of late HIV diagnosis is advocated for, to guide future intervention research and to inform public policy and practice targeted at 'difficult to reach' populations.
Vanderbilt University Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN 37203, USA. abraham.mukolo@vanderbilt.edu
Abraham
A
Mukolo
Raquel
R
Villegas
Muktar
M
Aliyu
Kenneth A
KA
Wallston
D015492:AIDS Serodiagnosis / Q000639:trends; D000223:Adaptation, Psychological; D018791:CD4 Lymphocyte Count; D057210:Delayed Diagnosis; D005239:Fear; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012307:Risk Factors; D012737:Sex Factors; D057545:Social Stigma; D013315:Stress, Psychological; D013997:Time Factors