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Decrease in late presentation for HIV care in Kinshasa, DRC, 2006-2020.

Nadine Mayasi Ngongo1, Hippolyte Situakibanza Nani-Tuma2, Marcel Mbula Mambimbi2

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AIDS Research and Therapy
|July 17, 2021
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Summary

Late presentation for HIV care is decreasing in Kinshasa, but remains high, especially in older adults. Continued efforts are needed to improve early diagnosis and treatment for better HIV outcomes.

Keywords:
HIV careKinshasaLate presentation

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Late presentation for Human Immunodeficiency Virus (HIV) care is a significant barrier to effective Antiretroviral Therapy (ART) outcomes.
  • It contributes to increased morbidity, mortality, and further transmission of HIV.
  • Understanding the prevalence and associated factors of late presentation is crucial for optimizing screening and intervention strategies.

Purpose of the Study:

  • To monitor the trends of late presentation for HIV care in Kinshasa, Democratic Republic of Congo (DRC).
  • To identify factors associated with late presentation for HIV care.
  • To inform public health strategies for improving early HIV diagnosis and care.

Main Methods:

  • A retrospective cohort study was conducted in Kinshasa, DRC.
  • Included 10,137 HIV-positive adults newly enrolled in care between January 2006 and June 2020.
  • Late presentation was defined using two criteria: WHO advanced HIV disease (WHO stage 3/4 or CD4 < 200 cells/mm³) and a more inclusive definition (WHO stage 3/4 or CD4 < 350 cells/mm³).

Main Results:

  • Overall, 45.9% to 47.5% of patients presented late for HIV care.
  • A significant decreasing trend in late presentation was observed, from 70.7% in 2013 to 23.4% in 2020 (using CD4 < 350 cells/mm³ definition).
  • Older age was significantly associated with a higher risk of late presentation (p < 0.0001), while sex had no observed impact.

Conclusions:

  • The frequency of late presentation for HIV care is declining in Kinshasa.
  • Sustained public health efforts are necessary to further reduce late diagnoses.
  • Specific attention should be directed towards addressing late diagnosis among older individuals.