title: Unmatched Case-Control Study on Late Presentation of HIV Infection in Santiago, Cape Verde (2004-2011).
abstract: Access to free antiretroviral therapy (ART) in Sub-Saharan Africa has been steadily increasing over the past decade. However, the success of large-scale ART programmes depends on timely diagnosis and early initiation of HIV care. This study characterizes late presenters to HIV care in Santiago (Cape Verde) between 2004 and 2011, and identifies factors associated with late presentation for care. We defined late presentation as persons presenting to HIV care with a CD4 count below 350 cells/mm³. An unmatched case-control study was conducted using socio-demographic and behavioural data of 368 individuals (191 cases and 177 controls) collected through an interviewer-administered questionnaire, comparing HIV patients late and early presented to care. Logistic regression was performed to estimate odds ratio and 95% confidence intervals. Results show that 51.9% were late presenters for HIV. No differences were found in gender distribution, marital status, or access to health services between cases and controls. Participants who undertook an HIV test by doctor indication were more likely to present late compared with those who tested for HIV by their own initiative. Also, individuals taking less time to initiate ART are more likely to present late. This study highlights the need to better understand reasons for late presentation to HIV care in Cape Verde. People in older age groups should be targeted in future approaches focused on late presenters to HIV care.
authors.affiliation: Ministry of Health, Palácio do Governo, Várzea-Praia C.P. 47, Santiago-Cape Verde. antonio.moreira@ms.gov.cv.
authors.forename: António L
authors.initials: AL
authors.lastname: Moreira
authors.affiliation: Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, Lisbon 1349-008, Portugal. ifronteira@ihmt.unl.pt.
authors.forename: Inês
authors.initials: I
authors.lastname: Fronteira
authors.affiliation: Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, Lisbon 1349-008, Portugal. figueiredo.augusto@ihmt.unl.pt.
authors.forename: Gonçalo Figueiredo
authors.initials: GF
authors.lastname: Augusto
authors.affiliation: Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, Lisbon 1349-008, Portugal. mrfom@ihmt.unl.pt.
authors.forename: Maria Rosario O
authors.initials: MR
authors.lastname: Martins
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D055726:Cabo Verde / Q000453:epidemiology; D016022:Case-Control Studies; D042241:Early Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: CD4 count; Cape Verde; HIV/AIDS; late presentation