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Delayed entry into health care for women with HIV disease
J R Ickovics1, B Forsyth, K A Ethier
1Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Objective:
The primary objective was to evaluate factors that might influence delayed entry into health care for women with HIV. Implications of time of diagnosis for early medical intervention was a focused aspect.
Procedure:
Structured clinical interviews were conducted with HIV-positive women (n = 48); these data were supplemented by medical chart reviews.
Measures:
Delayed entry into health care was operationalized as a difference of more than 3 months between diagnosis and entry into care. Measures of race, social class, risk behavior circumstances of HIV testing, and health status were included.
Results:
Of women, 58% delayed entry into care following an HIV diagnosis. Upon entry into health care, 65% of women were symptomatic and 40% were severely immunocompromised (CD4 cells/mm3 < 200). Results from the logistic regression indicated that those who learned their HIV status prenatally were four times more likely to delay entry into care compared to those who self-referred for HIV testing, even after controlling for symptom status.
Conclusions:
HIV diagnosis is not enough to ensure that women with HIV will get adequate and timely health care. Counseling and testing recommendations should highlight the intrinsic value of early diagnosis.