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Access and engagement in HIV care among a national cohort of women living with HIV in Canada.

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Title: Access and engagement in HIV care among a national cohort of women living with HIV in Canada.
Authors: Kronfli, Nadine (AUTHOR), Lacombe-Duncan, Ashley (AUTHOR), Wang, Ying (AUTHOR), de Pokomandy, Alexandra (AUTHOR), Kaida, Angela (AUTHOR), Logie, Carmen (AUTHOR), Conway, Tracey (AUTHOR), Kennedy, V. Logan (AUTHOR), Burchell, Ann (AUTHOR), Tharao, Wangari (AUTHOR), Pick, Neora (AUTHOR), Kestler, Mary (AUTHOR), Sereda, Paul (AUTHOR), Loutfy, Mona (AUTHOR), on behalf of the CHIWOS Research Team# (AUTHOR)
Source: AIDS Care. Oct2017, Vol. 29 Issue 10, p1235-1242. 8p.
Subjects: Health services accessibility, Diagnosis, HIV-positive persons, Longitudinal method, Medical errors, Logistic regression analysis, Treatment delay (Medicine)
Geographic Terms: Canada
Abstract: Attrition along the cascade of HIV care poses significant barriers to attaining the UNAIDS targets of 90-90-90 and achieving optimal treatment outcomes for people living with HIV. Understanding the correlates of attrition is critical and particularly for women living with HIV (WLWH) as gender disparities along the cascade have been found. We measured the proportion of the 1425 WLWH enrolled in the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) who had never accessed HIV medical care, who reported delayed linkage into HIV care (>3 months between diagnosis and initial care linkage), and who were not engaged in HIV care at interview (<1 visit in prior year). Correlates of these cascade indicators were determined using univariate and multivariable logistic regression. We found that 2.8% of women had never accessed HIV care. Of women who had accessed HIV care, 28.7% reported delayed linkage and 3.7% were not engaged in HIV care. Indigenous women had higher adjusted odds of both a lack of access and delayed access to HIV care. Also, a younger age, unstable housing, history of recreational drug use, and experiences of everyday racism emerged as important barriers to ever accessing care. Programmatic efforts to support early linkage to and engagement in care for WLWH in Canada must address several social determinants of health, such as housing insecurity and social exclusion, and prioritize engagement of Indigenous women through culturally safe and competent practices. [ABSTRACT FROM PUBLISHER]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Access and engagement in HIV care among a national cohort of women living with HIV in Canada.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22AIDS+Care%22&quot;&gt;AIDS Care&lt;/searchLink&gt;. Oct2017, Vol. 29 Issue 10, p1235-1242. 8p.
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  Data: Attrition along the cascade of HIV care poses significant barriers to attaining the UNAIDS targets of 90-90-90 and achieving optimal treatment outcomes for people living with HIV. Understanding the correlates of attrition is critical and particularly for women living with HIV (WLWH) as gender disparities along the cascade have been found. We measured the proportion of the 1425 WLWH enrolled in the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) who had never accessed HIV medical care, who reported delayed linkage into HIV care (&gt;3 months between diagnosis and initial care linkage), and who were not engaged in HIV care at interview (&lt;1 visit in prior year). Correlates of these cascade indicators were determined using univariate and multivariable logistic regression. We found that 2.8% of women had never accessed HIV care. Of women who had accessed HIV care, 28.7% reported delayed linkage and 3.7% were not engaged in HIV care. Indigenous women had higher adjusted odds of both a lack of access and delayed access to HIV care. Also, a younger age, unstable housing, history of recreational drug use, and experiences of everyday racism emerged as important barriers to ever accessing care. Programmatic efforts to support early linkage to and engagement in care for WLWH in Canada must address several social determinants of health, such as housing insecurity and social exclusion, and prioritize engagement of Indigenous women through culturally safe and competent practices. [ABSTRACT FROM PUBLISHER]
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  Data: &lt;i&gt;Copyright of AIDS Care is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=124435093
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2017.1338658
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 1235
    Subjects:
      – SubjectFull: Health services accessibility
        Type: general
      – SubjectFull: Diagnosis
        Type: general
      – SubjectFull: HIV-positive persons
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Medical errors
        Type: general
      – SubjectFull: Logistic regression analysis
        Type: general
      – SubjectFull: Treatment delay (Medicine)
        Type: general
      – SubjectFull: Canada
        Type: general
    Titles:
      – TitleFull: Access and engagement in HIV care among a national cohort of women living with HIV in Canada.
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              Text: Oct2017
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