title: Factors associated with a delay in seeking HIV/AIDS treatment in São Paulo, Brazil.
abstract: This quantitative cross-sectional study of HIV/AIDS patients (N = 1,520) in São Paulo evaluated factors associated with a delay in seeking care. Analysis included Chi square tests and multiple logistic regression. Care was sought at the AIDS stage in 56.7 % (861) of patients, and 48.2 % (732) had a CD4 count ≤350 cells/mm(3); 9 % (136) delayed seeking care for 6 months or more after a positive HIV test. Women sought medical care earlier after testing (odds ratio (OR) = 1.79; P = 0.0227), but were already symptomatic (OR = 1.90; P = 0.0004). Partners of seropositive patients (OR = 3.92; P = 0.0000) also sought care symptomatic. Reasons for late presentation for care were non-acceptance of HIV diagnosis (OR = 24.56; P = 0.0000), treatment refusal (OR = 55.34; P = 0.0000), and physical disability (OR = 1.90; P = 0.0414). Necessary strategies for HIV treatment and prevention include improved education and access to services.
authors.affiliation: Universidade Federal de São Paulo, Bloc A1. 2nd Floor, Room 211, Av. Albert Einstein 627 Morumbi, São Paulo, SP, 05651-901, Brazil, zarifa@einstein.br.
authors.forename: Zarifa
authors.initials: Z
authors.lastname: Khoury
authors.forename: Rebeca S
authors.initials: RS
authors.lastname: Silva
authors.forename: Wilza
authors.initials: W
authors.lastname: Villela
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data; D055815:Young Adult