Determinants of late-stage HIV disease at diagnosis in Singapore, 1996 to 2009
Annals of the Academy of Medicine, Singapore
;
: 194-199, 2012.
Article
in English
| WPRIM
| ID: wpr-299658
ABSTRACT
<p><b>INTRODUCTION</b>The delay in HIV diagnosis has been identified as a significant reason for late presentation to medical care. This research aims to elucidate the significant determinants of late-stage HIV infection in Singapore between 1996 and 2009, after the advent of highly active anti-retroviral therapies.</p><p><b>MATERIALS AND METHODS</b>We included 3735 patients infected via sexual mode of transmission from the National HIV Registry diagnosed between 1996 and 2009. Late-stage HIV infection is defined as CD4 count less than 200 mm(3) or AIDS-defining opportunistic infections at fi rst diagnosis or within one year of HIV diagnosis. We determined independent epidemiological risk factors for late-stage HIV infection at first diagnosis using multivariate logistic regression.</p><p><b>RESULTS</b>Multivariate analysis showed that older age corresponded significantly with increasing odds of late-stage HIV infection. Compared to persons diagnosed at 15 to 24 years of age, those diagnosed at age 55 years and above were associated with 5-fold increased likelihood of late-stage infection (adjusted odds ratio (AOR) 5.17; 95% CI, 3.21 to 8.33). Chinese ethnicity, singlehood, and non-professional occupations were also significantly associated with late-stage HIV infection. Persons detected in the course of medical care had over 3.5 times the odds of late-stage infection (AOR 3.55; 95% CI, 2.71 to 4.65). Heterosexual mode of transmission and having sex workers and social escorts as sexual partners, were the other epidemiological risk factors with significant associations.</p><p><b>CONCLUSION</b>The findings of this study emphasises the need to increase HIV awareness and to encourage early and regular HIV testing among at-risk persons.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Sexual Behavior
/
Singapore
/
HIV Infections
/
Logistic Models
/
Registries
/
Epidemiology
/
Retrospective Studies
/
Risk Factors
/
Age Factors
/
HIV
Type of study:
Diagnostic study
/
Etiology study
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Observational study
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Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2012
Type:
Article
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