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J Int Assoc Provid AIDS Care. 2017 Mar/Apr;16(2):168-173. doi: 10.1177/2325957416686194. Epub 2016 Dec 30.

Factors Associated with Delayed Enrollment in HIV Medical Care among HIV-Positive Individuals in Odessa Region, Ukraine.

Author information

1
1 Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
2
2 Ukrainian I. I. Mechnikov Research Anti-Plague Institute, Odessa, Ukraine.
3
3 WHO Country Office in Ukraine, Kyiv, Ukraine.
4
4 Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
5
5 Department of Epidemiology and Biostatistics, SUNY Downstate School of Public Health, Brooklyn, NY, USA.
6
6 Department of English, Stony Brook University, Stony Brook, NY, USA.

Abstract

In Ukraine, about one-third of identified HIV-positive individuals are not connected to care. We conducted a cross-sectional survey (n = 200) among patients registered at Odessa AIDS centers in October to December 2011. Factors associated with delayed enrollment in HIV care (>3 months since positive HIV test) were evaluated using logistic regression. Among study participants (mean age 35 ± 8.2 years, 47.5% female, 42.5% reported history of injecting drugs), 55% delayed HIV care enrollment. Odds of delayed enrollment were higher for those with lower educational attainment (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [CI]: 1.04-6.76), not feeling ill (aOR: 2.98, 95% CI: 1.50-5.93), or not having time to go to the AIDS center (aOR: 3.89, 95% CI: 1.39-10.89); injection drug use was not associated with delayed enrollment. Programs linking HIV-positive individuals to specialized care should address enrollment barriers and include education on HIV care benefits and case management for direct linkage to care. HIV testing and treatment should be coupled to ensure a continuum of care.

KEYWORDS:

HIV care; Ukraine; barriers to care; delayed HIV care entry; linkage to care

PMID:
28034344
PMCID:
PMC5363501
DOI:
10.1177/2325957416686194
[Indexed for MEDLINE]
Free PMC Article

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