Why do sub-Saharan Africans present late for HIV care in Switzerland?

Details

Serval ID
serval:BIB_30340E1FC965
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Why do sub-Saharan Africans present late for HIV care in Switzerland?
Journal
HIV medicine
Author(s)
Hachfeld A., Darling K., Calmy A., Ledergerber B., Weber R., Battegay M., Wissel K., Di Benedetto C., Fux C.A., Tarr P.E., Kouyos R., Ruggia L.S., Furrer H.J., Wandeler G.
Working group(s)
Swiss HIV Cohort Study
Contributor(s)
Aubert V., Battegay M., Bernasconi E., Böni J., Braun D.L., Bucher H.C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C.A., Günthard H.F., Haerry D., Hasse B., Hirsch H.H., Hoffmann M., Hösli I., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kouyos R.D., Kovari H., Ledergerber B., Martinetti G., Martinez de Tejada B., Marzolini C., Metzner K.J., Müller N., Nicca D., Pantaleo G., Paioni P., Rauch A., Rudin C., Scherrer A.U., Schmid P., Speck R., Stöckle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S.
ISSN
1468-1293 (Electronic)
ISSN-L
1464-2662
Publication state
Published
Issued date
07/2019
Peer-reviewed
Oui
Volume
20
Number
6
Pages
418-423
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Late presentation (LP) to HIV care disproportionally affects individuals from sub-Saharan Africa (SSA). We explored the reasons for late presentation to care among this group of patients in the Swiss HIV Cohort Study.
The prevalence of LP was compared between patients from Western Europe (WE) and those from SSA enrolled between 2009 and 2012. Patients were asked about HIV testing, including access to testing and reasons for deferring it, during face-to-face interviews.
The proportion of LP was 45.8% (435/950) among patients from WE, and 64.6% (126/195) among those from SSA (P < 0.001). Women from WE were slightly more likely to present late than men (52.6% versus 44.5%, respectively; P = 0.06), whereas there was no sex difference in patients from SSA (65.6% versus 63.2%, respectively; P = 0.73). Compared with late presenters from WE, those from SSA were more likely to be diagnosed during pregnancy (9.1% versus 0%, respectively; P < 0.001), but less likely to be tested by general practitioners (25.0% versus 44.6%, respectively; P = 0.001). Late presenters from SSA more frequently reported 'not knowing about anonymous testing possibilities' (46.4% versus 27.3%, respectively; P = 0.04) and 'fear about negative reaction in relatives' (39.3% versus 21.7%, respectively; P = 0.05) as reasons for late testing. Fear of being expelled from Switzerland was reported by 26.1% of late presenters from SSA.
The majority of patients from SSA were late presenters, independent of sex or education level. Difficulties in accessing testing facilities, lack of knowledge about HIV testing and fear-related issues are important drivers for LP in this population.
Keywords
Adult, Africa South of the Sahara, Delayed Diagnosis/statistics & numerical data, Emigrants and Immigrants, Female, HIV Infections/diagnosis, Health Services Accessibility, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Prospective Studies, Switzerland, HIV, late presentation, sub-Saharan Africans
Pubmed
Web of science
Create date
27/05/2019 16:31
Last modification date
23/06/2020 5:21
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