Comparison of Late HIV Diagnosis as a Marker of Care for Aboriginal Versus Non-Aboriginal People Living with HIV in Ontario. Issue 4 (2012)

• Record Type: Journal Article
• Authors: Jaworsky, Denise; Monette, LaVerne; Raboud, Janet; O'Brien-Teengs, Doe; Diong, Christina; Blitz, Sandra; Rourke, Sean B; Loutfy, Mona R; OHTN Cohort Study Team,
• Is Part Of: Canadian journal of infectious diseases & medical microbiology =. Volume 23:Issue 4(2012)
• Page Start: e96
• Page End: e102
• Publication Date: 2012
• Subjects: Aboriginal peoples -- Access to care -- Cohort study -- HIV -- HIV diagnosis -- Quality of care; Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable diseases; Infection; Communicable Diseases; Communicable Disease Control; Electronic journals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.9
• DOI: 10.1155/2012/930289
• Languages: English
• ISSNs: 1712-9532

Abstract

Abstract : BACKGROUND: Studies have found that Aboriginal people living with HIV/AIDS (APHAs) are more likely than non-APHAs to receive suboptimal HIV care, yet achieve similar clinical outcomes with proper care. OBJECTIVE: To compare the proportions of individuals diagnosed late with HIV between APHAs and non-APHAs within the Ontario HIV Treatment Network Cohort Study (OCS). METHODS: The analysis included OCS participants who completed the baseline visit by November 2009. Two definitions of the outcome of late HIV diagnosis were used: the proportion of participants with an AIDS-defining illness (ADI) before or within three months of HIV diagnosis; and the proportion of participants with a CD4 + count <200 cells/mL at diagnosis. Logistic regression analysis was used to assess the association between Aboriginal ethnicity and late HIV diagnosis. RESULTS: APHAs were more likely to be female and have lower income, education and employment. No statistically significant differences were noted in the proportions receiving a late HIV diagnosis defined by ADI (Aboriginal 5.2% versus non-Aboriginal 6.3%; P=0.40). Multivariate logistic regression analysis revealed a significant association between Aboriginal ethnicity and late HIV diagnosis defined by CD4 + count after adjusting for age and HIV risk factor (OR 1.55; P=0.04). DISCUSSION: APHAs were more likely to have a CD4 + count <200 cells/mL at diagnosis but had similar clinical outcomes from late diagnosis when defined by ADI. However, differences may be underestimated due to recruitment limitations and selection bias. CONCLUSION: Additional work is needed to address the socioeconomic and health care needs of APHAs.