Delayed Treatment for People Living with HIV in China, 2004–2016: An Analysis of An Observational Cohort
Abstract
:1. Introduction
2. Methods
2.1. Data Sources and Study Samples
2.2. Measurements
2.3. Data Analyses
3. Results
4. Discussion
4.1. Implications for Health Policy
4.2. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Year | Treatment Thresholds |
---|---|
2002 [13] | CD4 <200 cells/μL |
2008 [14] | CD4 <350 cells/μL |
2014 [15] | CD4 <500 cells/μL |
2016 [16,17] | No threshold. All are recommended treatment. |
Variables | Items | Value | Percentage (%) |
---|---|---|---|
Gender | Male | 12,144 | 71.6 |
Female | 4813 | 28.4 | |
Age (years, mean ± SD) | All | 40.0 ± 13.3 | -- |
Marital status | Unmarried | 4598 | 27.1 |
Married | 9390 | 55.4 | |
Divorced/Widowed | 2886 | 17.0 | |
Missing | 83 | 0.5 | |
Employment | Worker | 719 | 4.2 |
Farmers | 4129 | 24.4 | |
No work/retired | 596 | 3.5 | |
Others | 898 | 5.3 | |
Missing | 10,615 | 67.9 | |
Ethnicity | Han | 4664 | 27.5 |
Others | 1710 | 10.1 | |
Missing | 10,583 | 72.5 | |
Education level | Primary school and below | 2157 | 12.7 |
Middle school | 2535 | 14.9 | |
High school | 857 | 5.1 | |
University and above | 708 | 4.2 | |
Missing | 10,700 | 63.1 | |
Mode of transmission | Homosexual | 751 | 4.4 |
Heterosexual | 9629 | 56.8 | |
Intravenous drug use | 5508 | 32.5 | |
Others | 997 | 5.9 | |
Missing | 72 | 0.4 | |
Year of ART initiation * | 2004 | 841 | 4.9 |
2005 | 838 | 4.9 | |
2006 | 1061 | 6.3 | |
2007 | 1362 | 8.0 | |
2008 | 1590 | 9.4 | |
2009 | 1510 | 8.9 | |
2010 | 1354 | 8.0 | |
2011 | 1562 | 9.2 | |
2012 | 1606 | 9.5 | |
2013 | 1556 | 9.2 | |
2014 | 1572 | 9.3 | |
2015 | 1229 | 7.3 | |
2016 | 816 | 4.8 | |
Missing | 60 | 0.4 |
Year | Number * | CD4 Counts (Cells/μL) * | Lag Time (Months) |
---|---|---|---|
2004 | 841 | 201 ± 147 | 59.2 ± 37.7 |
2005 | 838 | 172 ± 132 | 36.6 ± 36.6 |
2006 | 1061 | 164 ± 138 | 27.0 ± 32.7 |
2007 | 1362 | 179 ± 139 | 26.3 ± 30.2 |
2008 | 1590 | 184 ± 139 | 19.6 ± 25.4 |
2009 | 1510 | 190 ± 171 | 18.0 ± 22.6 |
2010 | 1354 | 201 ± 162 | 14.5 ± 18.1 |
2011 | 1562 | 212 ± 167 | 10.7 ± 14.1 |
2012 | 1606 | 228 ± 188 | 6.1 ± 9.2 |
2013 | 1556 | 241 ± 203 | 3.9 ± 6.7 |
2014 | 1572 | 239 ± 199 | 2.0 ± 4.0 |
2015 | 1229 | 238 ± 207 | 1.4 ± 2.8 |
2016 | 816 | 324 ± 238 | 0.9 ± 1.6 |
Variables | Late Testing | Delayed Access to ART |
---|---|---|
Covariate a | AOR (95%CI) | AOR (95%CI) |
Gender | ||
Female | 1.15 (0.84,1.56) | 0.88 (0.81,0.97) |
Male (Ref) | 1 | 1 |
Age (continuous) | 0.69 (0.54,0.87) | 0.69 (0.65,0.72) |
Marital status (p < 0.001) | ||
Married | 1.23 (0.79,1.91) | 0.63 (0.57,0.69) |
Divorced or widowed | 0.99 (0.68,1.46) | 0.75 (0.66,0.85) |
Unmarried (Ref) | 1 | 1 |
Ethnicity | ||
Others | 1.22 (0.93,1.61) | 0.912(0.71,1.17) |
Han (Ref) | 1 | 1 |
Education level (continuous) | 1.04 (0.90, 1.20) | 0.88(0.80, 0.97) |
Employment (p < 0.001) | ||
Farmers | 0.74(0.52,1.06) | 1.03(0.77,1.38) |
No work or retired | 0.89(0.62,1.28) | 1.24(0.92,1.67) |
Others | 0.69(0.48,1.00) | 1.30(0.93,1.82) |
Worker (Ref) | 1 | 1 |
Mode of transmission (p < 0.001)** | ||
Heterosexual/MSM (Ref) | 1.30(0.79,2.14) | 0.96(0.80,1.14) |
PWID/ MSM (Ref) | 1.16(0.74,1.82) | 3.58(2.95,4.33) |
PWID/ Heterosexual(Ref) | 0.89(0.50,1.60) | 1.04(0.84,1.30) |
Year of diagnosis (continuous) | 1.13(1.09,1.18) | 1.06(1.03,1.08) |
CD4 count at diagnosis(Continuous) | - | 1.27(1.21,1.33) |
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Xu, J.; Sönnerborg, A.; Gao, L.; Wang, P.; Bouey, J.Z.H.; Cheng, F. Delayed Treatment for People Living with HIV in China, 2004–2016: An Analysis of An Observational Cohort. Int. J. Environ. Res. Public Health 2020, 17, 1809. https://doi.org/10.3390/ijerph17051809
Xu J, Sönnerborg A, Gao L, Wang P, Bouey JZH, Cheng F. Delayed Treatment for People Living with HIV in China, 2004–2016: An Analysis of An Observational Cohort. International Journal of Environmental Research and Public Health. 2020; 17(5):1809. https://doi.org/10.3390/ijerph17051809
Chicago/Turabian StyleXu, Junfang, Anders Sönnerborg, Liangmin Gao, Peicheng Wang, Jennifer Z.H. Bouey, and Feng Cheng. 2020. "Delayed Treatment for People Living with HIV in China, 2004–2016: An Analysis of An Observational Cohort" International Journal of Environmental Research and Public Health 17, no. 5: 1809. https://doi.org/10.3390/ijerph17051809