142nd APHA Annual Meeting and Exposition

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309474
Late HIV presentation in men who have sex with men in Portugal: Are there target groups for testing promotion?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Cláudia Carvalho , Institute of Public Health of the University of Porto, Porto, Portugal
Raquel Lucas , Institute of Public Health of the University of Porto, Porto, Portugal
Ana Martins , Institute of Public Health of the University of Porto, Porto, Portugal
Ricardo Fuertes , GAT - Grupo Português de Activistas sobre o Tratamento de VIH/Sida Pedro Santos
Luis Mendão , GAT - Grupo Português de Activistas sobre o Tratamento de VIH/Sida Pedro Santos
Maria-José Campos , GAT - Grupo Português de Activistas sobre o Tratamento de VIH/Sida Pedro Santos
Henrique Barros , Institute of Public Health of the University of Porto, Porto, Portugal
Late HIV diagnosis is associated with increased morbidity and mortality, and missed opportunities to reduce the population frequency of high-risk contacts. We describe characteristics of late HIV presenters (LP) among men who have sex with men (MSM) in a concentrated epidemic country.

Data was obtained during the European MSM Internet Survey that took place from June 4 to August 21, 2010. An anonymous questionnaire was completed online (35 European countries using 25 languages) comprising 5187 subjects living in Portugal. Data included HIV testing, HIV status, CD4-count at diagnosis, sociodemographic and behavioral characteristics. LP was defined as <350 CD4 at diagnosis. Proportions were compared using the Chi-squared test.

Among the 3723 (71.8%) men who ever received an HIV test result, 405 (10.9%) reported to be positive, 186 knew their CD4 count at diagnosis, and 69 (37.1%) were LP. Older MSM (≥ 40 years)  were more often LP than younger MSM (<25 and 25-39 years) (46.2% vs 38.9% vs 32.8%); MSM with a lower educational level reported LP more often (56.3% vs. 43.3%, medium vs. 30.6% higher, p=0.06); LP was similar in men born in Portugal or abroad (38.1% vs. 37.7%)  but more frequent in participants with history of drug injection (61.5% vs. 35.9%, p=0.06). Late presenters were more commonly diagnosed hospital inpatients (64.3% vs. 34.9% in other sites p=0.029)

Late presenters did not significantly differ from remaining MSM in most usually assessed characteristics. Increasing the offer of HIV testing might benefit from a whole-population approach rather than a high-risk one.

Learning Areas:

Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the characteristics of late HIV presenters (LP) among men who have sex with men (MSM) in a concentrated epidemic setting. Assess the ability for selective vs. universal approaches

Keyword(s): HIV/AIDS, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a young MD specialist in HIV infection preparing my PhD. I am involved in patient diagnosis, treatment and care. I was part of the EMIS study in Portugal and draft the abstract
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.