High prevalence of late diagnosis of HIV in Mexico during the HAART era

Salud Publica Mex. 2012 Oct;54(5):506-14. doi: 10.1590/s0036-36342012000500007.

Abstract

Objective: To evaluate the prevalence of late HIV diagnosis (CD4<200 cell/mm³) in an HIV clinic in Mexico City between 2001-2008, to assess changes in this prevalence across the study period, and to determine the risk factors associated to late testing (LT).

Materials and methods: Cross-sectional analysis including all patients recently diagnosed as HIV. We estimated the proportion of LT patients and compared demographic characteristics between those and all other. We determine the risk factors associated to LT using logistic regression methods.

Results: Sixty one percent of LT patients present when are diagnosed for the first time. The prevalence did not decrease between 2001 and 2008 (p=0.37). Older age (OR: 2.4; 95%CI 1.2-4.7), unemployment (OR: 1.75; 95%CI 1.12-2.75) and less than nine years of education (OR: 2.44; 95%CI 1.37-4.33) were independently associated to LT, in a multivariate analysis.

Conclusion: LT has high prevalence in Mexico, this impact on antiretroviral effectiveness and perhaps on HIV transmission. Policies for HIV-prevention in Mexico need to be modified to reduce LT prevalence including more aggressive strategies of testing.

MeSH terms

  • AIDS Serodiagnosis / statistics & numerical data
  • AIDS Serodiagnosis / trends
  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active*
  • Cross-Sectional Studies
  • Delayed Diagnosis*
  • Educational Status
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Humans
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Outpatient Clinics, Hospital / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data
  • Prevalence
  • Risk Factors
  • Socioeconomic Factors
  • Tertiary Care Centers / statistics & numerical data
  • Unemployment / statistics & numerical data
  • Urban Population / statistics & numerical data
  • Young Adult