title: Multidimensional patient-reported problems within two weeks of HIV diagnosis in East Africa: a multicentre observational study.
abstract: OBJECTIVE
  We aimed to determine for the first time the prevalence and severity of multidimensional problems in a population newly diagnosed with HIV at outpatient clinics in Africa.
  
  
  METHODS
  Recently diagnosed patients (within previous 14 days) were consecutively recruited at 11 HIV clinics in Kenya and Uganda. Participants completed a validated questionnaire, the African Palliative Outcome Scale (POS), with three underpinning factors. Ordinal logistic regression was used to evaluate risk factors for prevalence and severity of physical, psychological, interpersonal and existential problems.
  
  
  RESULTS
  There were 438 participants (62% female, 30% with restricted physical function). The most prevalent problems were lack of help and advice (47% reported none in the previous 3 days) and difficulty sharing feelings. Patients with limited physical function reported more physical/psychological (OR = 3.22) and existential problems (OR = 1.54) but fewer interpersonal problems (OR = 0.50). All outcomes were independent of CD4 count or ART eligibility.
  
  
  CONCLUSIONS
  Patients at all disease stages report widespread and burdensome multidimensional problems at HIV diagnosis. Newly diagnosed patients should receive assessment and care for these problems. Effective management of problems at diagnosis may help to remove barriers to retention in care.
authors: London School of Hygiene and Tropical Medicine, London, United Kingdom. Victoria.simms@lshtm.ac.uk
authors: Victoria
authors: V
authors: Simms
authors: Nancy
authors: N
authors: Gikaara
authors: Grace
authors: G
authors: Munene
authors: Mackuline
authors: M
authors: Atieno
authors: Jeniffer
authors: J
authors: Kataike
authors: Clare
authors: C
authors: Nsubuga
authors: Geoffrey
authors: G
authors: Banga
authors: Eve
authors: E
authors: Namisango
authors: Suzanne
authors: S
authors: Penfold
authors: Peter
authors: P
authors: Fayers
authors: Richard A
authors: RA
authors: Powell
authors: Irene J
authors: IJ
authors: Higginson
authors: Richard
authors: R
authors: Harding
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D001294:Attitude to Health; D018791:CD4 Lymphocyte Count; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000523:psychology*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult