HIV infection: time from diagnosis to initiation of antiretroviral therapy in Portugal, a multicentric study

Bibliographic Details
Main Author: Nicolau, Vanessa
Publication Date: 2021
Other Authors: Cortes, Rui, Lopes, Maria, Virgolino, Ana, Santos, Osvaldo, Martins, António, Faria, Nancy, Reis, Ana Paula, Santos, Catarina, Maltez, Fernando, Ayres Pereira, Álvaro, Antunes, Francisco
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10451/49009
Summary: © 2021 by the authors. 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/).
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spelling HIV infection: time from diagnosis to initiation of antiretroviral therapy in Portugal, a multicentric studyPersons living with HIVCare continuumART initiationSystems for referralCare cascade© 2021 by the authors. 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/).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.MDPIRepositório da Universidade de LisboaNicolau, VanessaCortes, RuiLopes, MariaVirgolino, AnaSantos, OsvaldoMartins, AntónioFaria, NancyReis, Ana PaulaSantos, CatarinaMaltez, FernandoAyres Pereira, ÁlvaroAntunes, Francisco2021-07-19T16:57:12Z20212021-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/49009engHealthcare 2021, 9, 79710.3390/healthcare90707972227-9032info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-03-17T14:35:27Zoai:repositorio.ulisboa.pt:10451/49009Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T03:16:30.697767Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv 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
spellingShingle HIV infection: time from diagnosis to initiation of antiretroviral therapy in Portugal, a multicentric study
Nicolau, Vanessa
Persons living with HIV
Care continuum
ART initiation
Systems for referral
Care cascade
title_short 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_sort HIV infection: time from diagnosis to initiation of antiretroviral therapy in Portugal, a multicentric study
author Nicolau, Vanessa
author_facet Nicolau, Vanessa
Cortes, Rui
Lopes, Maria
Virgolino, Ana
Santos, Osvaldo
Martins, António
Faria, Nancy
Reis, Ana Paula
Santos, Catarina
Maltez, Fernando
Ayres Pereira, Álvaro
Antunes, Francisco
author_role author
author2 Cortes, Rui
Lopes, Maria
Virgolino, Ana
Santos, Osvaldo
Martins, António
Faria, Nancy
Reis, Ana Paula
Santos, Catarina
Maltez, Fernando
Ayres Pereira, Álvaro
Antunes, Francisco
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Nicolau, Vanessa
Cortes, Rui
Lopes, Maria
Virgolino, Ana
Santos, Osvaldo
Martins, António
Faria, Nancy
Reis, Ana Paula
Santos, Catarina
Maltez, Fernando
Ayres Pereira, Álvaro
Antunes, Francisco
dc.subject.por.fl_str_mv Persons living with HIV
Care continuum
ART initiation
Systems for referral
Care cascade
topic Persons living with HIV
Care continuum
ART initiation
Systems for referral
Care cascade
description © 2021 by the authors. 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/).
publishDate 2021
dc.date.none.fl_str_mv 2021-07-19T16:57:12Z
2021
2021-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/49009
url http://hdl.handle.net/10451/49009
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Healthcare 2021, 9, 797
10.3390/healthcare9070797
2227-9032
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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