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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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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