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HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study
The benefits of antiretroviral therapy (ART) for persons living with HIV (PLWH) are well established. Rapid ART initiation can lead to improved clinical outcomes. Portugal has one of the highest rates of new HIV diagnoses in the European Union, and an average time until ART initiation above the reco...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306717/ https://www.ncbi.nlm.nih.gov/pubmed/34202051 http://dx.doi.org/10.3390/healthcare9070797 |
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author | Nicolau, Vanessa Cortes, Rui Lopes, Maria Virgolino, Ana Santos, Osvaldo Martins, António Faria, Nancy Reis, Ana Paula Santos, Catarina Maltez, Fernando Pereira, Álvaro Ayres Antunes, Francisco |
author_facet | Nicolau, Vanessa Cortes, Rui Lopes, Maria Virgolino, Ana Santos, Osvaldo Martins, António Faria, Nancy Reis, Ana Paula Santos, Catarina Maltez, Fernando Pereira, Álvaro Ayres Antunes, Francisco |
author_sort | Nicolau, Vanessa |
collection | PubMed |
description | The benefits of antiretroviral therapy (ART) for persons living with HIV (PLWH) are well established. Rapid ART initiation can lead to improved clinical outcomes. Portugal has one of the highest rates of new HIV diagnoses in the European Union, and an average time until ART initiation above the recommendations established by the national guideline according to data from the first two years after its implementation in 2015, with no more recent data available after that. This study aimed to evaluate time from the first hospital appointment until ART initiation among newly diagnosed HIV patients in Portugal between 2017 and 2018, to investigate differences between hospitals, and to understand the experience of patient associations in supporting the navigation of PLWH throughout referral and linkage to the therapeutic process. To answer to these objectives, a twofold design was followed: a quantitative approach, with an analysis of records from five Portuguese hospitals, and a qualitative approach, with individual interviews with three representatives of patient associations. Overall, 847 and 840 PLWH initiated ART in 2017 and in 2018, respectively, 21 days (median of the two years) after the first appointment, with nearly half coming outside the mainstream service for hospital referral, and with observed differences between hospitals. In 2017–2018, only 38.0% of PLWH initiated ART in less than 14 days after the first hospital appointment. From the interviews, barriers of administrative and psychosocial nature were identified that may hinder access to ART. Patient associations work to offer a tailored support to patients’ navigation within the health system, which can help to reduce or overcome those potential barriers. Indicators related to time until ART initiation can be used to monitor and improve access to specialized care of PLWH. |
format | Online Article Text |
id | pubmed-8306717 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83067172021-07-25 HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study Nicolau, Vanessa Cortes, Rui Lopes, Maria Virgolino, Ana Santos, Osvaldo Martins, António Faria, Nancy Reis, Ana Paula Santos, Catarina Maltez, Fernando Pereira, Álvaro Ayres Antunes, Francisco Healthcare (Basel) Article The benefits of antiretroviral therapy (ART) for persons living with HIV (PLWH) are well established. Rapid ART initiation can lead to improved clinical outcomes. Portugal has one of the highest rates of new HIV diagnoses in the European Union, and an average time until ART initiation above the recommendations established by the national guideline according to data from the first two years after its implementation in 2015, with no more recent data available after that. This study aimed to evaluate time from the first hospital appointment until ART initiation among newly diagnosed HIV patients in Portugal between 2017 and 2018, to investigate differences between hospitals, and to understand the experience of patient associations in supporting the navigation of PLWH throughout referral and linkage to the therapeutic process. To answer to these objectives, a twofold design was followed: a quantitative approach, with an analysis of records from five Portuguese hospitals, and a qualitative approach, with individual interviews with three representatives of patient associations. Overall, 847 and 840 PLWH initiated ART in 2017 and in 2018, respectively, 21 days (median of the two years) after the first appointment, with nearly half coming outside the mainstream service for hospital referral, and with observed differences between hospitals. In 2017–2018, only 38.0% of PLWH initiated ART in less than 14 days after the first hospital appointment. From the interviews, barriers of administrative and psychosocial nature were identified that may hinder access to ART. Patient associations work to offer a tailored support to patients’ navigation within the health system, which can help to reduce or overcome those potential barriers. Indicators related to time until ART initiation can be used to monitor and improve access to specialized care of PLWH. MDPI 2021-06-25 /pmc/articles/PMC8306717/ /pubmed/34202051 http://dx.doi.org/10.3390/healthcare9070797 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Nicolau, Vanessa Cortes, Rui Lopes, Maria Virgolino, Ana Santos, Osvaldo Martins, António Faria, Nancy Reis, Ana Paula Santos, Catarina Maltez, Fernando Pereira, Álvaro Ayres Antunes, Francisco HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study |
title | HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study |
title_full | HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study |
title_fullStr | HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study |
title_full_unstemmed | HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study |
title_short | HIV Infection: Time from Diagnosis to Initiation of Antiretroviral Therapy in Portugal, a Multicentric Study |
title_sort | hiv infection: time from diagnosis to initiation of antiretroviral therapy in portugal, a multicentric study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306717/ https://www.ncbi.nlm.nih.gov/pubmed/34202051 http://dx.doi.org/10.3390/healthcare9070797 |
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