Linkage to care of patients living with HIV/ AIDS in a reference hospital of Minas Gerais, Brazil

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Background: Linkage is the second step in the HIV care continuum and can be defined as the first clinic visit after diagnosis to an outpatient provider with prescribing privileges in an HIV care setting. Linkage is essential to assess patient health, provide access to antiretroviral therapy (ART), as well as prevention and care interventions. Objectives: To describe the linkage profile and the sociodemographic and clinical characteristics of patients under care in public hospital specialized in HIV/ AIDS care in Belo Horizonte, Minas Gerais, Brazil. Methods: Cross-sectional study of 208 HIV-infected adults linked between January and December 2015 to a reference hospital (Hospital Eduardo de Menezes) which is specialized in inpatient and outpatient care of infectious diseases, especially tuberculosis, AIDS and leprosy. Linkage was defined as the first outpatient visit to this service after HIV diagnosis, assessed through patients’ medical records. Results: Most patients (77%) were linked to care within 90 days of diagnosis. The mean linkage time was 138 ± 37 days. Most patients were male (78%), with a mean age of 39.3 ± 11.9 years old and median of 38 years old, non-white skin color (76%), unmarried (71%), residents of Belo Horizonte (70%) and had used tobacco (83%), alcohol (60%) and illicit drugs (43%) at least once in lifetime. Half of patients had eight or less years of schooling (51%), had children (52%) and had a job (52%). More than half of patients had an AIDS-defining clinical condition at the time of linkage (56%). Conclusions: The results show a high prevalence of linkage with late diagnosis, which may lead to worse prognosis and higher costs with treatment. A better understanding on how HIV-infected people use outpatient and inpatient care is essencial to improve care assessment and provision.

Abstract

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HIV, AIDS, Pacientes, Terapia antirretroviral

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HIV, AIDS, Pacientes, Terapia antirretroviral

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https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275

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