Differences in Reasons for Late Presentation to HIV Care in Uganda Among Men and Women

Sarah M. Lofgren; Sharon Tsui; Nakita Natala; Noeline Nakasujja; Raymond Sebuliba; Jane Francis Ndyetukira; Anita Arinda; Vanessa Akinyange; Kathy H. Hullsiek; Elizabeth Nalintya; Alisat Sadiq; Katelyn Pastick; Anna Stadleman; David B Meya; David R. Boulware

doi:10.1007/s10461-022-03764-9

Differences in Reasons for Late Presentation to HIV Care in Uganda Among Men and Women

Sarah M. Lofgren, Sharon Tsui, Nakita Natala, Noeline Nakasujja, Raymond Sebuliba, Jane Francis Ndyetukira, Anita Arinda, Vanessa Akinyange, Kathy H. Hullsiek, Elizabeth Nalintya, Alisat Sadiq, Katelyn Pastick, Anna Stadleman, David B Meya, David R. Boulware

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3 Scopus citations

Abstract

Late presentation to HIV care, i.e., presenting with < 200 CD4 cells/mL, is associated with higher mortality and worse outcomes. Despite that, a quarter of people living with HIV in Uganda still present late to care. We surveyed Ugandans living with HIV who enrolled in clinic ≤ 90 days prior. We compared groups who presented 'late' with CD4 < 200 and 'early' with CD4 > 350, stratifying by sex. We found men who presented late had higher externalized stigma than early presenters. Thirty-six percent of the entire cohort were depressed. Social support was stronger in late presenters versus early, although weak overall. Social support was inversely correlated with depression, with social support dropping as depression increased. Interventions to improve clinic privacy, reduce stigma, improve social support, and help women disclose their HIV status to male partners are needed to reduce late presentation to HIV care.

Original language	English (US)
Pages (from-to)	303-313
Number of pages	11
Journal	AIDS and Behavior
Volume	27
Issue number	1
DOIs	https://doi.org/10.1007/s10461-022-03764-9
State	Published - Jan 2023

Bibliographical note

Funding Information:
This research was supported by the Fogarty International Center (Grant No. R25TW009345), the National Institute of Allergy and Infectious Diseases (Grant No. T32AI055433), and the National Institute of Mental Health (Grant No. K23MH121220). We thank all of the participants in the study. RedCAP: This research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences.

Funding Information:
This research was supported by the Fogarty International Center (Grant No. R25TW009345), the National Institute of Allergy and Infectious Diseases (Grant No. T32AI055433), and the National Institute of Mental Health (Grant No. K23MH121220).

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

HIV care
HIV stigma
Late presentation
Sex differences
Universal test and treat

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10461-022-03764-9

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Lofgren, S. M., Tsui, S., Natala, N., Nakasujja, N., Sebuliba, R., Ndyetukira, J. F., Arinda, A., Akinyange, V., Hullsiek, K. H., Nalintya, E., Sadiq, A., Pastick, K., Stadleman, A., Meya, D. B., & Boulware, D. R. (2023). Differences in Reasons for Late Presentation to HIV Care in Uganda Among Men and Women. AIDS and Behavior, 27(1), 303-313. https://doi.org/10.1007/s10461-022-03764-9

Lofgren, SM, Tsui, S, Natala, N, Nakasujja, N, Sebuliba, R, Ndyetukira, JF, Arinda, A, Akinyange, V, Hullsiek, KH, Nalintya, E, Sadiq, A, Pastick, K, Stadleman, A, Meya, DB & Boulware, DR 2023, 'Differences in Reasons for Late Presentation to HIV Care in Uganda Among Men and Women', AIDS and Behavior, vol. 27, no. 1, pp. 303-313. https://doi.org/10.1007/s10461-022-03764-9

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abstract = "Late presentation to HIV care, i.e., presenting with < 200 CD4 cells/mL, is associated with higher mortality and worse outcomes. Despite that, a quarter of people living with HIV in Uganda still present late to care. We surveyed Ugandans living with HIV who enrolled in clinic ≤ 90 days prior. We compared groups who presented 'late' with CD4 < 200 and 'early' with CD4 > 350, stratifying by sex. We found men who presented late had higher externalized stigma than early presenters. Thirty-six percent of the entire cohort were depressed. Social support was stronger in late presenters versus early, although weak overall. Social support was inversely correlated with depression, with social support dropping as depression increased. Interventions to improve clinic privacy, reduce stigma, improve social support, and help women disclose their HIV status to male partners are needed to reduce late presentation to HIV care.",

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AU - Ndyetukira, Jane Francis

AU - Arinda, Anita

AU - Akinyange, Vanessa

AU - Hullsiek, Kathy H.

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AU - Sadiq, Alisat

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Differences in Reasons for Late Presentation to HIV Care in Uganda Among Men and Women

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Publisher link

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