Factors Influencing the Initiation of Treatment after the Diagnosis of Korean Patients with HIV

Mi-So Shim; Gwang Suk Kim; Chang Gi Park

doi:10.12799/jkachn.2018.29.3.279

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Shim, Kim, and Park: Factors Influencing the Initiation of Treatment after the Diagnosis of Korean Patients with HIV

Original Article

Journal of Korean Academy of Community Health Nursing 2018; 29(3): 279-289.

Published online: 28 September 2018

DOI: https://doi.org/10.12799/jkachn.2018.29.3.279

Factors Influencing the Initiation of Treatment after the Diagnosis of Korean Patients with HIV

Mi-So Shim¹

, Gwang Suk Kim²

, Chang Gi Park³

¹Doctoral Student, College of Nursing, Yonsei University, Seoul, Korea.

²Professor, College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea.

³Assistant Research Professor, College of Nursing, University of Illinois at Chicago, Illinois, USA.

Corresponding author: Kim, Gwang Suk. College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3342, Fax: +82-2-392-5440, gskim@yuhs.ac

Received 19 February 2018 Revised 19 July 2018 Accepted 21 July 2018

Korean Academy of Community Health Nursing

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study has been conducted to identify factors that influence the initiation of treatment after the diagnosis of Korean patients with HIV.

Methods

A cross-sectional study design was used, and 290 patients with HIV from outpatient departments of 7 hospitals participated. Self-report questionnaires included items on the days from the primary diagnosis to the initiation of treatment, and the patients' demographic and disease related characteristics. Negative binomial regression model (NBR) was utilized to determine risk factors influencing the initiation of treatment after the diagnosis of the patients with HIV.

Results

The skewness of days was 6.62, and the degree of asymmetry of distribution was severe. In NBR, patients who were in their 40s and 50s, female, unmarried and living with their family, jobless, in a middle or high level of economic status, and diagnosed before 2014 showed a higher risk of delayed treatment than patients who were younger, male, married and living with family, in a low level of economic status, and diagnosed in 2014 or afterwards.

Conclusion

The findings suggest the necessity of intervention to promote HIV patients' early entry into treatment based on the participants' characteristics.

Keywords: HIV, Time-to-treatment, Risk factors

Figures and Tables

Table 1

Characteristics of Distribution of Dependent Variables

Table 2

Differences in Time to Treatment according to Characteristics of Participants (N=290)

^†Missing values are not included; ^‡It includes 3 categories: a) married & alone, b) married & with friend/lover, shelter, etc, c) divorced/separated/widowed & with friend/lover, shelter, etc.

Table 3

Negative Binomial Regression for Time to Treatment (N=290)

CI=confidence interval; LL=lower limit; UL=upper limit; Ref.=reference group; It includes 3 categories: 1) married & alone, 2) married & with friend/lover, shelter, etc, 3) divorced/separated/widowed & with friend/lover, shelter, etc.

Notes

This work was supported by the National Research Foundation of Korea under Grant number NRF-2015R1D1A1A01057423.

References

1. Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013; 382(9903):1525–1533. DOI: 10.1016/S0140-6736(13)61809-7.

2. The Joint United Nations Programme on HIV/AIDS. Ending AIDS: progress towards the 90-90-90 targets [Internet]. Geneva: The Joint United Nations Programme on HIV/AIDS;2017. cited 2018 January 3. Available from: http://www.unaids.org/sites/default/files/media_asset/Global_AIDS_update_2017_en.pdf.

3. The Joint United Nations Programme on HIV/AIDS. Ending AIDS: progress towards the 90-90-90 targets [Internet]. Geneva: The Joint United Nations Programme on HIV/AIDS;2017. cited 2018 January 3. Available from: http://www.unaids.org/sites/default/files/media_asset/Global_AIDS_update_2017_en.pdf.

4. Grinsztejn B, Hosseinipour MC, Ribaudo HJ, Swindells S, Eron J, Chen YQ, et al. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: Results from the phase 3 HPTN 052 randomised controlled trial. Lancet Infect Dis. 2014; 14(4):281–290. DOI: 10.1016/S1473-3099(13)70692-3.

5. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011; 365(6):493–505. DOI: 10.1056/NEJMoa1105243.

6. Insight Start Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015; 2015(373):795–807. DOI: 10.1056/NEJMoa1506816.

7. Centers for Disease Control & Prevention. Division of HIV/AIDS Prevention Strategic Plan 2017-2020 [Internet]. Georgia: Centers for Disease Control & Prevention;2018. cited 2018 May 30. Available from: https://www.cdc.gov/hiv/pdf/dhap/cdc-hiv-dhap-external-strategic-plan.pdf.

8. The Korean Society for AIDS. The 2013 clinical guidelines for the diagnosis and treatment of HIV/AIDS in HIV-infected Koreans. Infect Chemother. 2013; 45(4):455–461. DOI: 10.3947/ic.2013.45.4.455.

9. Liu Y, Ruan Y, Vermund SH, Osborn CY, Wu P, Jia Y, et al. Predictors of antiretroviral therapy initiation: A cross-sectional study among Chinese HIV-infected men who have sex with men. BMC Infect Dis. 2015; 15(1):570. DOI: 10.1186/s12879-015-1309-x.

10. Palmer AK, Cescon A, Chan K, Cooper C, Raboud JM, Miller CL, et al. Factors associated with late initiation of highly active antiretroviral therapy among young HIV-positive men and women aged 18 to 29 years in Canada. J Int Assoc Provid AIDS Care. 2014; 13(1):56–62. DOI: 10.1177/2325957413510606.

11. Hsu LC, Truong HHM, Vittinghoff E, Zhi Q, Scheer S, Schwarcz S. Trends in early initiation of antiretroviral therapy and characteristics of persons with HIV initiating therapy in San Francisco, 2007-2011. J Infect Dis. 2013; 209(9):1310–1314. DOI: 10.1093/infdis/jit599.

12. Alvarez-Uria G. Factors associated with delayed entry into HIV medical care after HIV diagnosis in a resource-limited setting: data from a cohort study in India. PeerJ. 2013; 1:e90. DOI: 10.7717/peerj.90.

13. Plitt SS, Mihalicz D, Singh AE, Jayaraman G, Houston S, Lee BE. Time to testing and accessing care among a population of newly diagnosed patients with HIV with a high proportion of Canadian Aboriginals, 1998-2003. AIDS Patient Care STDS. 2009; 23(2):93–99. DOI: 10.1089/apc.2007.0238.

14. Newman CE, Bonar M, Greville HS, Thompson SC, Bessarab D, Kippax SC. Barriers and incentives to HIV treatment uptake among Aboriginal people in Western Australia. AIDS. 2007; 21:S13–S17. DOI: 10.1097/01.aids.0000255080.46976.18.

15. Begley K, McLaws ML, Ross MW, Gold J. Cognitive and behavioural correlates of non-adherence to HIV anti-retroviral therapy: Theoretical and practical insight for clinical psychology and health psychology. Clin Psychol (Aust Psychol Soc). 2008; 12(1):9–17. DOI: 10.1080/09540121.2015.1114992.

16. Park Y, Seo MJ, Kim S, Park S. Experience of treatment adherence in Korean patients with HIV. J Korean Acad Nurs. 2014; 44(4):407–417. DOI: 10.4040/jkan.2014.44.4.407.

17. Park YM, Shin G, Kim J. Factors influencing health-promoting behaviors in people living with HIV. Korean J Adult Nurs. 2014; 26(2):234–243. DOI: 10.7475/kjan.2014.26.2.234.

18. Coxe S, West SG, Aiken LS. The analysis of count data: a gentle introduction to Poisson regression and its alternatives. J Pers Assess. 2009; 91(2):121–136. DOI: 10.1080/00223890802634175.

19. Alvarez-Uria G, Pakam R, Midde M, Naik PK. Predictors of delayed antiretroviral therapy initiation, mortality, and loss to followup in HIV infected patients eligible for HIV treatment: Data from an HIV cohort study in India. Biomed Res Int. 2013; 2013:849042. DOI: 10.1155/2013/849042.

20. Cescon A, Patterson S, Davey C, Ding E, Raboud JM, Chan K, et al. Late initiation of combination antiretroviral therapy in Canada: A call for a national public health strategy to improve engagement in HIV care. J Int AIDS Soc. 2015; 18(1):20024. DOI: 10.7448/IAS.18.1.20024.

21. Kohli R, Klein RS, Schoenbaum EE, Anastos K, Minkoff H, Sacks HS. Aging and HIV infection. J Urban Health. 2006; 83(1):31–42. DOI: 10.1007/s11524-005-9005-6.

22. Illa L, Echenique M, Jean GS, Bustamante-Avellaneda V, Metsch L, Mendez-Mulet L, et al. Project ROADMAP: Reeducating Older Adults in Maintaining AIDS Prevention: A secondary intervention for older HIV-positive adults. AIDS Educ Prev. 2010; 22(2):138–147. DOI: 10.1521/aeap.2010.22.2.138.

23. Messer LC, Quinlivan EB, Parnell H, Roytburd K, Adimora AA, Bowditch N, et al. Barriers and facilitators to testing, treatment entry, and engagement in care by HIV-positive women of color. AIDS Patient Care STDS. 2013; 27(7):398–407. DOI: 10.1089/apc.2012.0435.

24. Logie CH, James L, Tharao W, Loutfy MR. HIV, gender, race, sexual orientation, and sex work: A qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada. PLoS Med. 2011; 8(11):e1001124. DOI: 10.1371/journal.pmed.1001124.

25. Alfonso V, Bermbach N, Geller J, Montaner JS. Individual variability in barriers affecting people's decision to take HAART: A qualitative study identifying barriers to being on HAART. AIDS Patient Care STDS. 2006; 20(12):848–857. DOI: 10.1089/apc.2006.20.848.

26. Seo MH, Jeong SH. Life experiences of uninfected women living with HIV-infected husbands: A phenomenological study. J Korean Acad Nurs. 2017; 47(6):781–793. DOI: 10.4040/jkan.2017.47.6.781.

27. Nakimuli-Mpungu E, Wamala K, Okello J, Alderman S, Odokonyero R, Mojtabai R, et al. Group support psychotherapy for depression treatment in people with HIV/AIDS in northern Uganda: A single-centre randomised controlled trial. Lancet HIV. 2015; 2(5):e190–e199. DOI: 10.1016/S2352-3018(15)00041-7.

28. Fox MP, Mazimba A, Seidenberg P, Crooks D, Sikateyo B, Rosen S. Barriers to initiation of antiretroviral treatment in rural and urban areas of Zambia: A cross-sectional study of cost, stigma, and perceptions about ART. J Int AIDS Soc. 2010; 13(1):8. DOI: 10.1186/1758-2652-13-8.

29. Posse M, Baltussen R. Barriers to access to antiretroviral treatment in Mozambique, as perceived by patients and health workers in urban and rural settings. AIDS Patient Care STDS. 2009; 23(10):867–875. DOI: 10.1089/apc.2009.0050.

30. Korea Centers for Disease Control & Prevention. 2018 HIV/AIDS management guideline [Internet]. Cheongju: Centers for Disease Control & Prevention;2017. cited 2018 May 30. Available from: http://www.cdc.go.kr/CDC/cms/content/mobile/74/77274_view.html.

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ORCID iDs

Mi-So Shim
https://orcid.org/0000-0001-9948-0662

Gwang Suk Kim
https://orcid.org/0000-0001-9823-6107

Chang Gi Park
https://orcid.org/0000-0003-3366-4279

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