Factors associated with a delay in seeking HIV/AIDS treatment in São Paulo, Brazil

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.