Comparison of late HIV diagnosis as a marker of care for Aboriginal versus non-Aboriginal people living with HIV in Ontario
Identifieur interne : 003447 ( Main/Exploration ); précédent : 003446; suivant : 003448Comparison of late HIV diagnosis as a marker of care for Aboriginal versus non-Aboriginal people living with HIV in Ontario
Auteurs : Denise Jaworsky [Canada] ; Laverne Monette ; Janet Raboud [Canada] ; Doe O Rien-Teengs [Canada] ; Christina Diong ; Sandra Blitz ; Sean B. Rourke [Canada] ; Mona R. Loutfy [Canada]Source :
- The Canadian Journal of Infectious Diseases & Medical Microbiology [ 1712-9532 ] ; 2012.
Abstract
Studies have found that Aboriginal people living with HIV/AIDS (APHAs) are more likely than non-APHAs to receive suboptimal HIV care, yet achieve similar clinical outcomes with proper care.
To compare the proportions of individuals diagnosed late with HIV between APHAs and non-APHAs within the Ontario HIV Treatment Network Cohort Study (OCS).
The analysis included OCS participants who completed the baseline visit by November 2009. Two definitions of the outcome of late HIV diagnosis were used: the proportion of participants with an AIDS-defining illness (ADI) before or within three months of HIV diagnosis; and the proportion of participants with a CD4+ count <200 cells/mL at diagnosis. Logistic regression analysis was used to assess the association between Aboriginal ethnicity and late HIV diagnosis.
APHAs were more likely to be female and have lower income, education and employment. No statistically significant differences were noted in the proportions receiving a late HIV diagnosis defined by ADI (Aboriginal 5.2% versus non-Aboriginal 6.3%; P=0.40). Multivariate logistic regression analysis revealed a significant association between Aboriginal ethnicity and late HIV diagnosis defined by CD4+ count after adjusting for age and HIV risk factor (OR 1.55; P=0.04).
APHAs were more likely to have a CD4+ count <200 cells/mL at diagnosis but had similar clinical outcomes from late diagnosis when defined by ADI. However, differences may be underestimated due to recruitment limitations and selection bias.
Additional work is needed to address the socioeconomic and health care needs of APHAs.
Url:
PubMed: 24294285
PubMed Central: 3597406
Affiliations:
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Le document en format XML
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</placeName>
<wicri:cityArea>Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto</wicri:cityArea>
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<author><name sortKey="Loutfy, Mona R" sort="Loutfy, Mona R" uniqKey="Loutfy M" first="Mona R" last="Loutfy">Mona R. Loutfy</name>
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<region type="state">Ontario</region>
</placeName>
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<affiliation wicri:level="2"><nlm:aff id="af9-jidmm23e096">Women and HIV Research Program, Women’s College Research Institute, Toronto, Ontario</nlm:aff>
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<front><div type="abstract" xml:lang="en"><sec><title>BACKGROUND:</title>
<p>Studies have found that Aboriginal people living with HIV/AIDS (APHAs) are more likely than non-APHAs to receive suboptimal HIV care, yet achieve similar clinical outcomes with proper care.</p>
</sec>
<sec><title>OBJECTIVE:</title>
<p>To compare the proportions of individuals diagnosed late with HIV between APHAs and non-APHAs within the Ontario HIV Treatment Network Cohort Study (OCS).</p>
</sec>
<sec><title>METHODS:</title>
<p>The analysis included OCS participants who completed the baseline visit by November 2009. Two definitions of the outcome of late HIV diagnosis were used: the proportion of participants with an AIDS-defining illness (ADI) before or within three months of HIV diagnosis; and the proportion of participants with a CD4<sup>+</sup>
count <200 cells/mL at diagnosis. Logistic regression analysis was used to assess the association between Aboriginal ethnicity and late HIV diagnosis.</p>
</sec>
<sec><title>RESULTS:</title>
<p>APHAs were more likely to be female and have lower income, education and employment. No statistically significant differences were noted in the proportions receiving a late HIV diagnosis defined by ADI (Aboriginal 5.2% versus non-Aboriginal 6.3%; P=0.40). Multivariate logistic regression analysis revealed a significant association between Aboriginal ethnicity and late HIV diagnosis defined by CD4<sup>+</sup>
count after adjusting for age and HIV risk factor (OR 1.55; P=0.04).</p>
</sec>
<sec><title>DISCUSSION:</title>
<p>APHAs were more likely to have a CD4<sup>+</sup>
count <200 cells/mL at diagnosis but had similar clinical outcomes from late diagnosis when defined by ADI. However, differences may be underestimated due to recruitment limitations and selection bias.</p>
</sec>
<sec><title>CONCLUSION:</title>
<p>Additional work is needed to address the socioeconomic and health care needs of APHAs.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>Canada</li>
</country>
<region><li>Ontario</li>
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<settlement><li>Toronto</li>
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</orgName>
</list>
<tree><noCountry><name sortKey="Blitz, Sandra" sort="Blitz, Sandra" uniqKey="Blitz S" first="Sandra" last="Blitz">Sandra Blitz</name>
<name sortKey="Diong, Christina" sort="Diong, Christina" uniqKey="Diong C" first="Christina" last="Diong">Christina Diong</name>
<name sortKey="Monette, Laverne" sort="Monette, Laverne" uniqKey="Monette L" first="Laverne" last="Monette">Laverne Monette</name>
</noCountry>
<country name="Canada"><region name="Ontario"><name sortKey="Jaworsky, Denise" sort="Jaworsky, Denise" uniqKey="Jaworsky D" first="Denise" last="Jaworsky">Denise Jaworsky</name>
</region>
<name sortKey="Loutfy, Mona R" sort="Loutfy, Mona R" uniqKey="Loutfy M" first="Mona R" last="Loutfy">Mona R. Loutfy</name>
<name sortKey="Loutfy, Mona R" sort="Loutfy, Mona R" uniqKey="Loutfy M" first="Mona R" last="Loutfy">Mona R. Loutfy</name>
<name sortKey="O Rien Teengs, Doe" sort="O Rien Teengs, Doe" uniqKey="O Rien Teengs D" first="Doe" last="O Rien-Teengs">Doe O Rien-Teengs</name>
<name sortKey="Raboud, Janet" sort="Raboud, Janet" uniqKey="Raboud J" first="Janet" last="Raboud">Janet Raboud</name>
<name sortKey="Rourke, Sean B" sort="Rourke, Sean B" uniqKey="Rourke S" first="Sean B" last="Rourke">Sean B. Rourke</name>
<name sortKey="Rourke, Sean B" sort="Rourke, Sean B" uniqKey="Rourke S" first="Sean B" last="Rourke">Sean B. Rourke</name>
<name sortKey="Rourke, Sean B" sort="Rourke, Sean B" uniqKey="Rourke S" first="Sean B" last="Rourke">Sean B. Rourke</name>
</country>
</tree>
</affiliations>
</record>
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