title: High prevalence of late diagnosis of HIV in Mexico during the HAART era.
abstract: OBJECTIVE
  To evaluate the prevalence of late HIV diagnosis (CD4<200 cell/mm³) in an HIV clinic in Mexico City between 2001-2008, to assess changes in this prevalence across the study period, and to determine the risk factors associated to late testing (LT).
  
  
  METHODS
  Cross-sectional analysis including all patients recently diagnosed as HIV. We estimated the proportion of LT patients and compared demographic characteristics between those and all other. We determine the risk factors associated to LT using logistic regression methods.
  
  
  RESULTS
  Sixty one percent of LT patients present when are diagnosed for the first time. The prevalence did not decrease between 2001 and 2008 (p=0.37). Older age (OR: 2.4; 95%CI 1.2-4.7), unemployment (OR: 1.75; 95%CI 1.12-2.75) and less than nine years of education (OR: 2.44; 95%CI 1.37-4.33) were independently associated to LT, in a multivariate analysis.
  
  
  CONCLUSIONS
  LT has high prevalence in Mexico, this impact on antiretroviral effectiveness and perhaps on HIV transmission. Policies for HIV-prevention in Mexico need to be modified to reduce LT prevalence including more aggressive strategies of testing.
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico.
authors.forename: Brenda
authors.initials: B
authors.lastname: Crabtree-Ramírez
authors.forename: Yanink
authors.initials: Y
authors.lastname: Caro-Vega
authors.forename: Francisco
authors.initials: F
authors.lastname: Belaunzarán-Zamudio
authors.forename: Juan
authors.initials: J
authors.lastname: Sierra-Madero
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data / Q000639:trends; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014478:Unemployment / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult