title: Time trends and correlates of late presentation for HIV care in Northern Greece during the decade 2000 to 2010.
abstract: BACKGROUND
  The aim of our study was to assess the extent of late presentation for HIV care in Northern Greece during the period 2000 to 2010 and to explore correlations aiming to provide guidance for future interventions.
  
  
  METHODS
  HIV-positive patients with no prior history of HIV care at presentation and with a CD4 T cell count within three months from the first confirmatory Western blot result were eligible for this study. Late presentation and advanced HIV disease were defined in concordance with the recommendations of the European Late Presenter Consensus working group. Time trends in presentation status and risk factors linked to late presentation and advanced HIV disease were identified in multivariable logistic regression models. Additional analyses after multiple imputation of missing values were performed to assess the robustness of our findings.
  
  
  RESULTS
  The status at presentation was evaluated for 631 eligible HIV-positive individuals. Overall, 52.5% (95% CI: 48.6% to 56.4%) of patients presented late for HIV care and 31.2% (95% CI: 27.6% to 34.8%) presented with advanced HIV disease. Time trends were consistent with an improvement in the presentation status of our study population (p<0.001). Risk factors associated with late presentation in multivariable logistic regression were intravenous drug use, heterosexual HIV transmission, immigrant status and age at diagnosis.
  
  
  CONCLUSIONS
  Despite the trend for improvement, a significant proportion of newly diagnosed HIV-positive patients present late for care. Targeted interventions with focus on social groups such as the elderly, persons who inject drugs, immigrants and individuals at risk for heterosexual HIV transmission are mandated.
authors.affiliation: Infectious Diseases Division, 1st Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. metallidissimeon@yahoo.gr
authors.forename: Simeon
authors.initials: S
authors.lastname: Metallidis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Pilalas
authors.forename: Lemonia
authors.initials: L
authors.lastname: Skoura
authors.forename: Anna-Bettina
authors.initials: AB
authors.lastname: Haidich
authors.forename: Olga
authors.initials: O
authors.lastname: Tsachouridou
authors.forename: Maria
authors.initials: M
authors.lastname: Papaioannou
authors.forename: Theofilos
authors.initials: T
authors.lastname: Chrysanthidis
authors.forename: Isidora
authors.initials: I
authors.lastname: Bakaimi
authors.forename: Zoe A
authors.initials: ZA
authors.lastname: Antoniadou
authors.forename: Apostolia
authors.initials: A
authors.lastname: Margariti
authors.forename: Nicolaos
authors.initials: N
authors.lastname: Malisiovas
authors.forename: Pavlos
authors.initials: P
authors.lastname: Nikolaidis
mesh_terms: D000367:Age Factors; D015153:Blotting, Western; D018791:CD4 Lymphocyte Count; D054242:Emigrants and Immigrants; D005260:Female; D006115:Greece / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy*; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology; D013997:Time Factors