title: Predictors of delayed entry into medical care of children diagnosed with HIV infection: data from an HIV cohort study in India.
abstract: Data about the attrition before entry into care of children diagnosed with HIV in low- or middle-income countries are scarce. The aim of this study is to describe the attrition before engagement in HIV medical care in 523 children who were diagnosed with HIV from 2007 to 2012 in a cohort study in India. The cumulative incidence of children who entered into care was 87.2% at one year, but most children who did not enter into care within one year were lost to followup. The mortality before entry into care was low (1.3% at one year) and concentrated during the first three months after HIV diagnosis. Factors associated with delayed entry into care were being diagnosed after mother's HIV diagnosis, belonging to scheduled castes, age<18 months, female gender, and living >90 minutes from the HIV centre. Children whose parents were alive and were living in a rented house were at a higher risk of delayed entry into care than those who were living in an owned house. The results of this study can be used to improve the linkage between HIV testing and HIV care of children diagnosed with HIV in India.
authors.affiliation: Department of Infectious Diseases, Bathalapalli Rural Development Trust Hospital, Kadiri Road, Bathalapalli, Anantapur District, Andhra Pradesh 515661, India.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Alvarez-Uria
authors.affiliation: Department of Infectious Diseases, Bathalapalli Rural Development Trust Hospital, Kadiri Road, Bathalapalli, Anantapur District, Andhra Pradesh 515661, India.
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Naik
authors.affiliation: Department of Infectious Diseases, Bathalapalli Rural Development Trust Hospital, Kadiri Road, Bathalapalli, Anantapur District, Andhra Pradesh 515661, India.
authors.forename: Manoranjan
authors.initials: M
authors.lastname: Midde
authors.affiliation: Department of Infectious Diseases, Bathalapalli Rural Development Trust Hospital, Kadiri Road, Bathalapalli, Anantapur District, Andhra Pradesh 515661, India.
authors.forename: Raghavakalyan
authors.initials: R
authors.lastname: Pakam
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D013997:Time Factors