9TH EUROPEAN AIDS CONFERENCE (EACS) 1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP October 25 - 29, 2003 Warsaw, Poland

Objective: To identify factors associated with delayed presentation to medical care after testing HIV positive and/or with HIV late testing.

Methods: Cross-sectional investigation of patients enrolled in a multicentre study in Italy from 1997 to 2000. Patients at their first HIV care visit were offered a questionnaire on HIV testing history, sexual and drug using behaviors. Delayed presenters were patients with a more than six months interval between their first HIV positive test and presentation for HIV care; late testers were patients with the first HIV positive test within six months and a CD4 count < 200 /mmc and/or clinically defined AIDS.

Results: Among the 968 study patients, 255 (26.3%) were delayed presenters, and 280 (28.9%) late testers. By multivariate analysis, drug injection significantly increased (odds ratio [OR]= 5.4) the probability of delayed presentation and, conversely, reduced (OR=0.6) the chance of late testing. Individuals with a history of HIV-negative test were at reduced risk of both delayed presentation and of late testing (OR=0.4). Unemployment was positively associated with delayed presentation and increasing age with late testing, whereas HIV counseling strongly (OR=0.4) reduced the chance of delayed presentation.

Conclusions: Interventions aimed at promoting timely access to care of persons with HIV infection should include differentiated programs that specifically address the problem of delay to presentation to medical care after testing HIV and the problem of testing late in the course of HIV infection.

Presenting Author: Dr. Enrico Girardi, INMI L. Spallanzani - Dept. of Epidemiology, Via Portuense 292, 00149, Roma, Italy, Phone: +39 0655170901

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